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HomeMy WebLinkAboutMezynieski, Steven M ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.northfork,net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Michelle 1. Martocchia, Southold Town Clerk's Office DATED: March 15,2006 RE: Cesspool Constmction! Alteration Application Transmitted herewith is a copy of application No. 3574 for a Cesspool/Septic Tank Construction! Alteration Permit submitted by: Steven M. Mezvnieski. 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 me. Thank you. * * * * * * * * * * * * I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE v- DISAPPROVE Comments: ~::~~ ~~:;:'Y- ~ J~ ?U.-4gl4 Signature o 3#vft" Dated I ' EUZABETH A. NEVILLE '. ~ TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER ...' Town Hall, 53095 Main Rolli .~ . P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown,northfork,net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRIcr APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential @$10 / or Non-Residential @$25_ Application No:=> 57( Permit No. ApplicantName ~.t~/"Y\ M. 1'Y1'Z~Y'H~1'.~ . Applicant Mailing Address liD IIhr+h IYInjl,L-L ~0Jy.J'/ J- j,u+ha.W\phlY) I\l~ IIq& ~ Septic TankLor Cesspool \J Brief Description of Proposed Constmction or Alterationtr>&k 1111-hGY\ 01 S1.l-t'-tn1k: ~ apprtJ'iftcJ '3.opf.L I()f\"f) ~uA,cn ~ R>l..in IMf'h/;'a :~tn)I" Location of Proposed Construction! Alteration: Owner of Property: _qr.(.v~f) fY7 I'JI7L'Z.~~ Owner Mailing Address:-'1.D . NN+h -n1Q ~7JJ, ,~.I' + _j~'1.l Hi "-nn/~Yl 1V'1 Owner Property Address: :s51o'15 tYJa In /2J Onit1t- . N~. . Name and phone number of contact perso~il'r1 r1~~ ~ . QOY' CllTl \ )lsll. ) 51sO - 01'5 Tax Map No:/OOO Section 01"'J Block 0 2.. Lot /0. I Cross Street i.lr1j La.n<. NOTE: LOCATION MAP MUST' BE SUBl\UlTED WITH APPLICATION. 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