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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK � P.O. Box 1179
REGISTRAR OF VITAL STATISTICS .�` Southold, New York 11971
MARRIAGE OFFICER rte® ''!. Fax (516) 765-1823
'4' i! Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 920 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL
Address 1 : 2760 YENNECOTT DRIVE
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
ADDITON OF AN OVERFLOW TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. HOLD 10'0" MAXIMUM SEPARATION BETWEEN OLD AND
NEW POOL. CALL FOR EXCAVATION INSPECTION.
Name Of Owner STARS, WILLIAM
Mailing Address 1 WICKHAM AVENUE
City St Zip MATTITUCK NY 11952
Property Address 1 WICKHAM AVENUE
City St Zip MATTITUCK NY 11952
Tax Map No. section 140.00 block 1 lot 3.000
Cross Street ROUTE 48
Building Permit Number Cross Reference:
Issue Date: 10/20/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY y`- ,A• �; Town Hall, 53095 Main Road
TOWN CLERK C `t P.O. BOX 1179
REGISTRAR OF VITAL STATISTICS :� Southold, New York 11971
MARRIAGE OFFICER �� (: ) �--�� Fax (516) 765-1823
��® 03 �!� Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK g = _
TOWN OF SOUTHOLD z 7 �.`�"�',j: -
October 14, 1992 'AI
��� OCT 4 4 199
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To: Southold Town Code Enforcement Officer T "`_
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From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A945 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for William Stars
Please review the application and location map and advise if this office may
issue the permit.
Please complete the form below and return it to this office.
Thank you.
cc
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - X
DISAPPROVE —
COMMENTS: ti. /8 i o III ....,. -
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Signature
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Date
Town Clerk Solrth'
OFFICE OF THE TOWN CLERK ,,,'",,,"
Town of Southold .011 �FF�[K
Judith T. Terry, • �0 Application No. f(27
y Town Clerk ��' � Gy'
Town Hall, 53095 Main Road �� 4. Construction
P. O. Box 1179Nc
,.Y, .
Southold, New York 11971 Alteration
Telephone ;y0� - $10.00 - Residential
(516) 765-1801 - �1 * ,, " $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$ /F.92-DATE (--)el �� / F `Z
- APPLICANT -NAME: o42,-`5.
APPLICANT ADDRESS: f76 2/5--/ I co 71 Pet
SEPTIC CESSPOOL
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DESCRIPTION OF PROPOSED CONST' CTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY:
OWNER MAILING ADDRESS: c r'GLa—
/72 7 12_ V
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OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section )1/e) Block / Lot
CROSS STREET: , ie/
BUILDING PERMIT NUMBER CROSS REFERENCE:
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RECEIVEDSignature of Applicant
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RECEIVED BY:
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