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JUDITH T. TERRY �, � _�, � � Town Hall, 53095 Main Road
TOWN CLERK .;1"
P.O. Box 1179
REGISTRAR OF VITAL STATISTICS EZ;gi, i, °� to Southold, New York 11971
Fax 6) 765-13
MARRIAGE OFFICER Telephone(5 6 ) 7651801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 711 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL SERVICE INC.
Address 1 : 2760 YENNECOTT DRIVE
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
ADDITION OF AN OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. DO NOT EXCEED 20' SEPARATION DISTANCE.
EXCAVATION INSPECTION REQUIRED. CALL THE BUILDING DEPARTMENT 765-1802
FOR AN APPOINTMENT.
Name Of Owner SULLIVAN, RAY
Mailing Address 1 BOISSEAU AVENUE
City St Zip SOUTHOLD NY 11971
Property Address 1 BOISSEAU AVENUE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 55.00 block 6 lot 1 .000
Cross Street YENNECOTT DRIVE
Building Permit Number Cross Reference:
Issue Date: 5/16/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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�� - ,°k �'� Town Hall, 53095 Main Road
+` - -,47�I' P.O. Box 1179
=�_,®� ,^ ND" Southold, New York 11971
JUDITH T. TERRY "'#'0/06 TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK _
TOWN OF SOUTHOLD r;�_)g -iI .. f
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May 8, 1991 �1i NI( MAY o 1991 Hi !)11
To: Southold Town Code Enforcement Officer "LI `uL« � Id,
TOWN 9t- S uj HOLD
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A729 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for J. Ray Sullivan .
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.
•
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - X
DISAPPROVE -
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OFFICE 'OF THE TOWN CLERK ,''
Town of Southold ,0 '���FFotKe'
Judith T. Terry, Town Clerk $Zc2?
Application No. 7
Town Hall, 53095 Main Road Z . Construction
P. O. Box 1179
Southold, New York 11971 tt9 � •• Alteration
Telephone =�®,y &•-i $10.00 - Residential
. (.516) 765-1801 1 4' ', " $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ l
I1
DATE /'�� n9/
APPLICANT NAME: /' G4' ets--Cf; � Sea6E
APPLICANT ADDRESS: .G ?eo Y� ' kCo r¢- „ia<
u_ 7 // /3- /777/
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONST CTION OR ALTERATION p
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRU TION OR ALTERATION:
OWNER OF PROPERTY: cam.
OWNER MAILING ADDRESS: OvT � /57z)`e
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: tIt6S--- -.�.Yd6
TAX MAP NO. : Section 575 Block Lot
CROSS STREET: yfotek,OrrBUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY: e' -' / 0.49 'Ze-c
`F '11161^R'g Office
DATE:
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