HomeMy WebLinkAboutWhite (4) Iow/I
JUDITH T. TERRY : Town Hall, 53095 Main Road
TOWN CLERK ® P.O. Box 1179
trsREGISTRAR OF VITAL STATISTICS � Southold, New York 11971
® � Fax Fax (516) 765-1823
MARRIAGE OFFICER �° I , Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER .1 NO
�I
FREEDOM OF INFORMATION OFFICER �:: � l����I
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1137 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL SERVICE
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. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS
BUILDINGS, PROPERTY LINES, WATERS BODIES, AND 2' ABOVE GROUND WATER.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner WHITE, WILLIAM
Mailing Address 1 805 ORCHARD STREET
City St Zip NEW SUFFOLK NY 11956
Property Address 1 805 ORCHARD STREET
City St Zip NEW SUFFOLK NY 11956
Tax Map No. section 117.00 block 5 lot 40.000
Cross Street NEW SUFFOLK ROAD
Building Permit Number Cross Reference:
Issue Date: 5/24/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
Ask-
/i 7
,,,,,,,
JUDITH T. TERRY O Town Hall, 53095 Main Road
TOWN CLERK ,1 T P.O. Box 1179
REGISTRAR OF VITAL STATISTICS if) �` Southold, New York 11971
Fax (516) 765-1823
MARRIAGE OFFICER y401 r
IP® � Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK RffilEawNr)
TOWN OF SOUTHOLD
TO: Southold Town Buildin MAY De artment I
FROM: Linda Cooper, Southold Town Clerk's Office
BLDG.Dear
DATED: May 17, 1994 TOWN UTFIOLD
•
Transmitted herewith is a copy of application No. 1176 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for William White
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 -
KCAVAlMS ECT 0'
DISAPPROVE - 5 DEQ JMED
COMMENTS: 4.7ii!:Z -/ Or-te,0/71--
10-1 1:72 `41.--411, , j") /'
e.-60 .P .7(.7 de"' e.e.44
Signat e
Dat '3-47 /42
•r
A
JFFICE OF THE TOWN CLERK ,,,'""""'
Town of Southold .0"cgto���'D Application No. lT 7e6Judith T. Terry, Town Clerk $,e
��
Town Hall, 53095 Main Road �� OY. Construction
P. 0. Box 1179 v rn
Southold, New York 11971 •tJ' � Alteration
Telephone -104. AC" $10.00 - Residential
(516) 765-1801 • = ®d * 1 S $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ Q
DATE /Ma/f /7, /` ?c{
A'PPLI'CANT NAME: /9166e415 �
APPLICANT ADDRESS: aV6o
SEPTIC CESSPOOL 15
DESCRIPTION OF PR POSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATIO :
-r.
OWNER OF PROPERTY: CA.) e Oj f
OWNER MAILING ADDRESS: Ob6"-- /j7-C-1-ed5.r
- Hp%
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: S`--� . T
TAX MAP NO. : Section //7 Block Lot 4/6
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY: ,R a
O Clerk's Office
DATE: MAY ' 71994
form Clerk ,Southold :�
e..0eri)
cSt
ti)
'I6.1 110 _
,
0 eiv„,:r9
r7 '
. .*
•