HomeMy WebLinkAboutCurry, Rita ill ii•__-
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JUDITH T.TERRY o < Town Hall,53095 Main Road
TOWN CLERK H Z ; P.O.Box 1179
,�� Southold,New York 11971
REGISTRAR OF VITAL STATISTICS Fax(516)765-1823
MARRIAGE OFFICER ` yn 0�O 11
RECORDS MANAGEMENT OFFICER 41.( * . ,, 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. 1355 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : WALTER MARCZEWSKI JR.
Address 1 : 1850 CARROLL AVENUE
City St Zip PECONIC NY 11958
Descripton of Proposed Construction or Alteration
ADDITION OF NEW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION
INSPECTION REQUIRED.
Name Of Owner CURRY, RITA
Mailing Address 1 38-15 149TH STREET
City St Zip FLUSHING NY 11354
Property Address 1 195 TOWN CREEK LANE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 64.00 block 1 lot 11 .002
Cross Street YOUNGS AVENUE
Building Permit Number Cross Reference:
Issue Date: 7/12/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY •• Z ` ; Town Hall, 53095 Main Road
TOWN CLERK :
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T P.O. Box 1179
to � Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ;V0 �� Fax (516) 765-1823
MARRIAGE OFFICER ��//�� .a��� s,� Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER ' / 411 $‘°,0.
FREEDOM OF INFORMATION OFFICER iii,
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: July 11, 1995
Transmitted herewith is a copy of application No. A 1407 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Country Cesspool for Rita Curry
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.
RECEIVED 411
411WIS 41
Sig ature
JUL 1 2 1995
Town CRNA ilooffnidDate
1
OFFICE OF THE TOWN CLERK ""'
Town of Southold tFOLKC'," /
Judith T. Terry, Town Clerk �G Application No. ( to 7
Town Hall, 53095 Main Road Construction
P. O. Box 1179
Southold, New York 11971 c � Alteration
Telephone ‘0,f ���►•� $10.00 - Residential
(516) 765-1801 ! 1 $ ''0 $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
APPLICANT NAME: /)/ /J '? "Vecec t/ 5-x- ✓/Z
APPLICANT ADDRESS: /95 p t--¢/,/^ e i( ,¢!/' e. /.7c COtt; C
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
,27-4/6'' // /t/c //C k/ //h
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 47/f4
OWNER MAILING ADDRESS: /,S - 0
J
OWNER PROPERTY ADDRESS: /f S' 7'®t,,"/V L,¢. <cc2cJ7A /4V'
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section 6r, Block r' Lot /7 .2
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE :
Signature of Applicant
RECEIVED BY: - (A)/(--P-4"---
Town Clerk's Office
DATE: i/ ( 93"
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