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HomeMy WebLinkAboutBerdinka, John c JUDITH T.TERRY � Oy` Town Hall, 53095 Main Road TOWN CLERK ` y Z • P. O. Box 1179 ,i Southold, New York 11971 REGISTRAR OF VITAL STATISTICS `C2 • 1� Fax(516) 765-1823 MARRIAGE OFFICER %#'* RECORDS MANAGEMENT OFFICER = 491 �1" Telephone(516) 765-1800 FREEDOM OF INFORMATION OFFICER ,.�� OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 1563 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : PECONIC CESSPOOL Address 1 : P. O. BOX 972 City St Zip MATTITUCK NY 11952 Descripton of Proposed Construction or Alteration REPLACE EXISTING CESSPOOL WITH NEW TYPE. APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS BUILDINGS, PROPERTY LINES, AND WATER BODIES. EXCAVATION INSPECTION REQUIRED. Name Of Owner BERDINKA, JOHN AND HELEN Mailing Address 1 1330 FACTORY AVENUE City St Zip MATTITUCK NY 11952 Property Address 1 1330 FACTORY AVENUE City St Zip MATTITUCK NY 11952 Tax Map No. section 142.00 block 1 lot 7.000 Cross Street SOUND AVENUE Building Permit Number Cross Reference: Issue Date: 11/01/96 Judith T. Terry Southold Town Clerk (TOWN SEAL) • • � ,,� S�FFoc,��o l 3 JUDITH T.TERRY 1 y< Town Hall, 53095 Main Road TOWN CLERK y = ; P.O. Box 1179 vrft $ Southold, New York 11971 REGISTRAR OF VITAL STATISTICS : O MARRIAGE OFFICER `y� '1�� Fax (516) 765-1823 RECORDS MANAGEMENT OFFICER : Ol • / Telephone (516) 765-1800 FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda Cooper, Southold Town Clerk's Office DATED: October 24, 1996 Transmitted herewith is a copy of application No. A1627 for an ALTERATION PERMIT for a cesspool or septic system submitted by Peconic Cesspool for John and Helen Berdinka 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 - DISAPPROVE - COMMENTS: Maintain required setbacks from adjacent wells, buildings, property lines and water bodies. EXCAVATION INSPECTION REQUIRED. 4.0 igna -re/ /0 Date f % OFFICE OF THE TOWN' CLERK ,,,,"""' • Town of Southold i''lFf 0� Judith T. Terry, Town Clerk ,'� ��� KCl/ Application 47/ 6 ..:17Town Hail, 53095 Main Road ;� � Construction P. 0. Box 1179 Southold, New York 11971 : s / 4t1 n. !A v to LI° fro/ (AL c3 re - N Gas W/ s =14