HomeMy WebLinkAboutKreitsek, William '_
��StFF0(,r
co -
JUDITH T.TERRY �� y< Town Hall, 53095 Main Road
TOWN CLERK ` ti = 4 P.O. Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS � 0 �, Fax(516) 765-1823�,
MARRIAGE OFFICER y
RECORDS MANAGEMENT OFFICER 49.( I 're" Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER ����•, ,•1"��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1465 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JEROME CONTRACTING
Address 1 : RD 3, MAPLE AVENUE
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
REPLACE THREE (3) SEPTIC TANKS.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION
INSPECTION REQUIRED.
Name Of Owner KREITSEK, WILLIAM AND DOLORES
Mailing Address 1 2455 NEW SUFFOLK AVENUE
City St Zip MATTITUCK NY 11952
Property Address 1 2455 NEW SUFFOLK AVENUE
City St Zip MATTITUCK NY 11952
Tax Map No. section 114.00 block 9 lot 14.001
Cross Street REEVE AVENUE
Building Permit Number Cross Reference:
Issue Date: 4/23/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
oft
S�
JUDITH T.TERRY � y1 Town Hall, 53095 Main Road
TOWN CLERK ; y = ; P.O. Box 1179
$ Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER : � O �I�
� ' Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER : of '1►���'� 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: April 23, 1996
Transmitted herewith is a copy of application No. A1526 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Jerome Contracting for William & Delores Kreitsek
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.
Signatur 7!
Dat
- 4 , ,
OFFICE OF THE TOWN CLERK
Town of Southold /5- -26
Judith T. Terry, Town Clerk Application No.
Town Hall, 53095 Main Road ; Construction
P. O. Box 1179 o Alteration `�—
Southold, New York 11971 . 141 W$ �.---
Telephone =0,1► stir ' $10.00 - Residential
(516) 765-1801 ! , �' $25.00 -Non-Residential
• -- ,,, 1,/
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE o2 3 J7/
APPLICANT NAME: ( 'f oyh Q aACT1'` •� °�
APPLICANT ADDRESS: g 2 PJ 942
Nr7
SCJ C, i'IfJ/� r / 7 /
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR AL ERATION
nee" -14&._e 3 /IC //;`.�/-c (3
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ��� , �}y,-� D0 Z- - 4 , Xe—elS c/�
OWNER MAILING ADDRESS: �y Sv Fr, ,fie
M
OWNER PROPERTY ADDRESS: #11 3 jJ ,dev -e
TELEPHONE NUMBER OF CONTACT PERS I N: <S y6 f
TAX MAP NO. : Section //y Block j Lot ///-
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signal of Applicant
RECEIVED BY: COs "
Town ierk s Office
DATE:
t _
CCfr
)pI
/0
4f1x`� s0, FFFL/< � � -�