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ELIZABETH A. NEVILLE /� . T 4. # Town Hall, 53095 Main Road
eveP.O. Box 1179
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TOWN CLERK ; ® m ,' �
REGISTRAR OF VITAL STATISTICS k '` , $ Southold, New York 11971
MARRIAGE OFFICER `W'®�\ ��1�, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER "�% �� 111 Fax
(631) 765-1800
FREEDOM OF INFORMATION OFFICER _ i"
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2546 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL INC
Address 1 : 2760 YENNECOTT DRIVE
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
ADDITION OF OVERFLOW EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner KENNEY, DANNY
Mailing Address 1 49205 MAIN ROAD
City St Zip SOUTHOLD NY 11971
Property Address 1 49205 MAIN ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 70.00 block 7 lot 2.000
Cross Street LOWER ROAD
Building Permit Number Cross Reference:
Issue Date: 4/17/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE ' �� g,% Town Hall, 53095 Main Road
TOWN CLERK 2 % P.O. Box 1179
REGISTRAR OF VITAL STATISTICS % vo Pt, i Southold, New York 11971
MARRIAGE OFFICER ,` _ Fax. 0 Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER �__'7®� _ ivr, II Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER '/
OFFICE OF THE TOWN CLERK r
TOWN OF SOUTHOLD ----,�s r n��'
TO: Southold Town Building Department i'' 'n ^-�� ;)001J�
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FROM: Linda J. Cooper, Southold Town Clerk's Office Tr•_--: (;F:::',-:,,;1.;O'2)
DATED: April 3, 2001
Transmitted herewith is a copy of application No. 2634 for a Cesspool/Septic Tank ALTERATION
Permit submitted by:
Dan Kenney by Morris Cesspool
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. .
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Dated
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OFFICE OF THE TOWN CLERK ,sso�F W ,
TON OF ,� ��'J CQG
WITy Application No.o'�6
ELIZABETH A.NEVILLE,TOWN CLERK
P.O.BOX 1179 Construction
SOUTHOLD,NEW YORK 11971 ; =v rn ; Alteration l/
Telephone ‘�O,y $10.00 - Residential t-
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(63t) 765-1800 =��1' ,,b ' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE 49A J O 1
APPLICANT NAME: - /401 2t 1S
APPLICANT ADDRESS: ' .2 26UPJ
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SEPTIC CESSPOOL.
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: `/
OWNER OF PROPERTY: 04-.0(Y)2)/ k/s/21�4Y
OWNER MAILING ADDRESS: 4/y'.03— it 22212
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OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 7,‘X-* 7,7 )
TAX MAP NO. : Section 9O Block Lot 2 •
CROSS STREET: /O (2eR
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED 'BY:
Town Clerk's Office
DATE:
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