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ELIZABETH A. NEVILLEo� Gya Town Hall, 53095 Main Road
TOWN CLERK _ , P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ` Southold, New York 11971
MARRIAGE OFFICER �� 4.4 ��111, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER "1 A iii Fax
(631) 765-1800
FREEDOM OF INFORMATION OFFICER ����
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2487 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL
Address 1 : 2760 YENNECOTT DRIVE
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
ADDITION OF OVERFLOW TO EXISTING SYSTEM.
APPLICATION APPROVED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner RADEMACHER, CLAUS
Mailing Address 1 136 EAST 73RD STREET
City St Zip NEW YORK NY 10021
Property Address 1 350 LAKESIDE DRIVE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 90.00 block 3 lot 16.000
Cross Street CEDAR INLET
Building Permit Number Cross Reference:
Issue Date: 12/29/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE -r1% Town Hall, 53095 Main Road
TOWN CLERK ; y 2 P.O. Box 1179
REGISTRAR OF VITAL STATISTICS
Southold, New York 11971
MARRIAGE OFFICER ®y ,co��/1 Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER ‘—.7491 • I•' Telephone (631) 765-1800
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FREEDOM OF INFORMATION OFFICER _ 'a
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: December 19, 2000
Transmitted herewith is a copy of application No. 2575 for a Cesspool/Septic Tank ALTERATION
Permit submitted by:
Morris Cesspool for Rademacher
Please review the application and location map and advise if the project has received Suffolk County
Health Department approval and if this office may issue the permit.
Please complete the form below and return it to me.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments: Maintain required setbacks from adjacent wells,buildings,property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED.
Signature
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Dated
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OFFICE of THE Towle CLERK vFFOLIr .
TOWN OF SOUTHOLD �� �J �'QG= Application No.p�575
FiJ7ABBTH A.NEVILLE,TOWN CLERK ��O • T.
P.O.BOX 1179 Construction
cc,
SOUTHOLD,NEW YORK 11971 v ris. I
• to �� Alteration ✓/
Telephone O,y tores, • $10.00 - Residential i/
(631-) 765-1800 -- t �,�'�, $25.00 -Non-Residential
-#000/
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
•
RECEIVED '
APPLICATION •
for DEC 1 9 2000 '
CONSTRUCTION or ALTERATION PERMIT
Southold Town Clerk
SEPTIC TANK or CESSPOOL
Permit No.
Fee '$
DATE ,9& - 1 f d7)
' APPLICANT NAME: /176R4/` Ce _ year? ,S6.X
APPLICANT ADDRESS: Z 260 M/VA1Ecarr otert
f uMo1I yY •
SEPTIC CESSPOOL
DESCRIPTION OFAOPOSED CONSTRUCTION OR ALTERATION
0"(-)-C-4t
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: •
• OWNER OF PROPERTY: C/41'`s 444465:.#f)efreirA
OWNER MAILING ADDRESS: 3 5-0 /,4/S/f10k Pie 5
5 o .1 t4oicia
OWNER PROPERTY ADDRESS: I3(0 13tr.4 9-.
N`( 10 Mai
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section g0 Block 2 Lot ✓6
CROSS STREET: - �A 42,1
BUILDING PERMIT NUMBER CROSS REFERENCE:
005,4 X 1/4
Signature of Applicant
RECEIVED BY: ,�0C4----
Town Clerk's Office
DATE: t Ia\nioo .
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