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Home My WebLink AboutJaswal f O• COG ELIZABETH A.NEVILLE 'yd Town Hall,53095 Main Road TOWN CLERK o - P.O.Box 1179 CSouthold New York 11971 REGISTRAR OF VITAL STATISTICS P ' Fax(631) 765-6145 MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER `�y'11 �a0- I Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER ,►�� southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 30620 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 TO EXISTING SYSTEM. APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION REQUIRED. Name of Owner JASWAL, SAROJ Mailing Address 1 22 NICOLE COURT City St Zip BOHEMIA NY 11716 Property Address 1 35900 MIDDLE ROAD City St Zip PECONIC NY 11716 Tax Map No. section 69.00 block 4 lot 5.000 Cross Street CAROLE Building Permit Number cross Reference: Issue Date: '7/29/03 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) ,� S0FF04 ELIZABETH A. NEVILLE 1�0 G'yd Town Hall, 53095 Main Road TOWN CLERK y - P.O. Box 1179 REGISTRAR OF VITAL STATISTICS v. i Southold, New York 11971 MARRIAGE OFFICER 4%. �� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER "'/�i ��o i�� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER �� southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 30620 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 TO EXISTING SYSTEM. APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION REQUIRED. Name Of Owner SAROJ JASWAL Mailing Address 1 22 NICOLE COURT City St Zip BOHEMIA NY 11716 Property Address 1 35900 MIDDLE ROAD City St Zip PECONIC NY 11716 Tax Map No. section 69 block 4 lot 5 Cross Street CAROLE Building Permit Number cross Reference: Issue Date: 7/29/03 Elizabeth A. Neville Southold Town clerk (TOWN SEAL) yam, ,`c" 3o62. r y I/o/O`OSVfFOUr �\ ELIZABETH A.NEVILLE ��`I Gy��, Town Hall, 53095 Main Road TOWN CLERK c - P.O.Box 1179 REGISTRAR OF VITAL STATISTICS eY Southold,New York 11971 MARRIAGE OFFICER `�o1,iL ��I� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER "'/o! ao iii Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER _ ,�� southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department 1i '"; L,L! UI\I .9 0 2Ofl ; + FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: June 30, 2003 �-- Transmitted herewith is a copy of application No. 3189 for a Cesspool/Septic Tank ALTERATION Permit submitted by: Morris Cesspool for Saroj Jaswal 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. * * * * * * * * * * * * 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. t 71(4....°146* i a S gn ture 0 0c)/03 Dated Pt •,,,,,,,,,,,,, ••• oFFour ELIZABETH A.NEVILLE 14�` OGif��` Town Hall, 53095 Main Road TOWN CLERK p P.O.Box 1179 ti Z Southold, New York 11971 REGISTRAR,OF VITAL STATISTICS • •• • MARRIAGE OFFICER •. VO i'. . . . . Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER y4','� a�ai.I Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER = * ,1southoldtown.northfork.net OFFICE*OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential @ $10 or Non-Residential @ $25 Application Nd._-j/e, Permit No. c Applicant Name -g Applicant Mailing Address A 766 04 Jou 1 Y Septic Tank or Cesspool !✓ Brief Descri t.on of Pro ed Constru tion or Alteration Location of Proposed Construction/Alteration: Owner of Property: $7Mtt5 0- C7�'$ Ccc�I - Owner Mailing Address: /71,•a a. 4'9 y /(?„5- Owner Property Address: oN ( aOC..6 a • _ 01-( / ) / 11)(/ /( 7/; Name and phone number of contact person Tax Map No: Section 1 Block ! Lot Cross Street C igAz-Q P NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL ,49 Signature of Applicant Date Received by: Town Of Southold P.O Box 1179 • -y Southold, NY 11971 * * * RECEIPT * * * Date: 06/30/03 Receipt#: 0 Transaction(s): Subtotal 1 Septic Permit- Construct- Resid. $10.00 Cash Total Paid: $10.00 Name: Morris, Cesspool 2760 Yennecott Drive Southold, NY 11971 Clerk ID: LINDAC Internal ID:78077