Loading...
HomeMy WebLinkAboutBerkoski, Antone e• wee o1 *+ ; Town Hall, 53095 Main Road cf) � `\ P.O. Box 1179 .a���' Southold, New York 11971 JUDITH T.TERRY �10'� i,� TELEPHONE TOWN CLERK �� (516) 765-1801 REGISTRAR OE VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No . 396 R Residential X Non-Residential Fee $ 10. 00 Septic Cesspool X PERMIT ISSUED TO: Name : BERKOSKI , DOROTHY Address 1 : P . 0 . BOX 868 City St Zip MATTITUCK NY 11952 Descripton of Proposed Construction or Alteration NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM. APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY HEALTH DEPARTMENT 11 /27/87 . Name Of Owner BERKOSKI , ANTONE Mailing Address 1 BERKOSKI , DOROTHY City St Zip MATTITUCK NY 11952 Property Address 1 COX LANE City St Zip CUTCHOGUE NY 11952 Tax Map No. section 83 . 00 block 3 lot 3 .002 Cross Street OREGON ROAD Building Permit Number Cross Reference : Issue Date : 9/14/88 Judith T . Terry Southold Town Clerk (TOWN SEAL) CE : , ` . %" :4' 3 -' i D , . „OOOOOO .. . ,..0 cr., , . ,st, i L,,,, ,, 1 or I 3 o Iry ' III .44a & z rYS ,, cn ,, � fa Town Hall, 53095 Main Road % ( �` �,' P.O. Box 1 179 � Southold, New York 11971 ` ✓ 1.! a ; JUDITH T.TERRY "71 r..'- TELEPHONE TOWN CLERK - (516) 765-1801 REGISTRAR Oi VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD • To: Victor Lessard, Southold Town Building Department From: Linda Cooper, Southold Town Clerk's Office Dated: September 13, 1988 Transmitted herewith is a copy of application No. 402 for a Cesspool/ Septic Tank Construction Permit submitted by: Antone and Dorothy Berkoski 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. Thank you. Linda J. Cooper * * * * * * * * * * * * I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE X DISAPPROVE Comments: ci.o .c..t..atic_ci'o S.- ere) cotroicateL au. .I ll 4-- ckir.0,..0_11 ti 1 . ,. I-I . ' 30.l.1-4 6._ ovN ‘i\A:\\1 1 () \r:a.,..,.. -c-,---.....,...., ,.A.S. Signature ci\ I .4\i i Dated OFFICE OF THE TOWN CLERK OFFULtj Town of Southold 0� 0 Judith T. Terry, Town Clerk - C Application No. Z/0 _2 .c . Town Hall, 53095 Main Road Construction P. O. Box 1179 Alteration Southold, New York 11971 Telephone _O! ila �� �• Residential (516) 765-1801 Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee $ DATE q I � � g 6 APPLICANT NAME: �, � '� -• ► APPLICANT ADDRESS: C d Q n 6 c3, SEPTIC ‘...---CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION_ 7jjjj LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION ORtALTERAT ON: I OWNER OF PROPERTY: E.> 11` na OWNER MAILING ADDRESS: r) OWNER PROPERTY ADDRES • • aw ) - • TELEPHONE NUMBER OF CONTACT PER ON:,11Ip j—3q , + Qqg - 3 S TAX MAP NO. : Section g 3 Block a Lot 3 CROSS STREET: BUILDING PERMIT NUMBER CROSS REFERENCE: • aL3C\714116 Sig ature •• Applicant RECEIVED BY: Town Clerk's Office DATE: .p 'I !""r SUFFOLK CO. HEALTH DEPT. APPRGYAt ;! •'.� e DA R R VAGAI�t T r• ' H. 5. NO. 386.77' EXPIRES I WO YEARS RhOI'fi I� OF AM1LY mil C ONLY w 5 ' 48a 311 0oK E. A+'PROVAL lam, - 8'j' - s O -ate.. __ tri • !� N STATEMENT OF INTENT ' N N THE WATER SUPPLY AND SEWAGE DISPOSAL �54) Tb GOf'`AG�i `, _ _ - _ _ - - _ - - -- < "� ~ `'` - "`"- --G�J SYSTEMS FOR THIS RESIDENCE WILL Q r�,� _ - - _ _ _ _ _ - - _ - - - Q CONFORM TO THE STANDARDS OF THE fi+�S e, • _ __ _ --� SUFFOL CO. Dia-T. OF EAL H S RVICES. ft 4 - - - 4 LL, I n \-- APPLICANT < . E / ---1J1 Na�E SUFFOLK COUNTY DEPT. OF HEALTH Q SERVICES - FOR APPROVAL OF PROPo5.O POOL t �h>r V CONSTRUCTION ONLY 7 ,,.. Go_ s�Pft� K - -_ - -- - - -- 55 O Q DATE: (1--Z7- _ _ " �r,�/ or " I - pR `3; 2.4, 2.� J. - `ES{OF/' y .�-•----- — 3 H. S. REF. NO.� j �L Ai ..... V m _- - - ' s = APPROVED:,- cA, ,.„, 0 41111111 I is UII►DIN 5 BAG 1 `' . '- 0 SUFFOLK CO. TAX MAP D IGNATION:. '( I 0 e{' GI K• �' 4- o DIST. SECT. BLOCK PCL. U � ��// �,!�� . 1000 083 3 P/o '� '1/fL'� tg � OWNERS ADDRESS: Z Jdi P.o. box 8a8 `''`- 5514.44' N. 4e le). Soy N. 3e6.i i' ` �l MArr1TUGk , N.Y, I I 2 to �916°. COX �..' L /c '1 o= ort.. 298 - ) �9i DEED: L. P. I - TEST HOLE STAMP I t.n er.;10.'i-Ai sDDAratiw,.or ee!ihi nt to the%tvevws is o viol htion of Se,"it,-,i 7W)A of tho New!York Ste* Tor o,L Fe,.vAiiea L.w. I " ---. - - -- I iP Gs e•*csF N ashrr►y Wore nct Irwin.) Map OF PROP R,1Y E GALE : so = t LOAM — �' a ,� � too/or >� SURVEYED POR ARIA : ScoG41- SQ. 11. -- - -- noidered tath.,avefi'frheoa s. Oo ROT Err ` P�N To�l R Ko s k I �ilhlrentflT� heDn?pn ahrlt Genius loon the"t�'+T'son her emo the"w'vtqrint 1 M( •mead•end on his behalf to the I thic evernmorttol ,L� kxwfiaio iihebQorh IiGlaj hexes and / ` COARSE to the ae nrroe of tho ionrinc moll-w/rindI • iutiarh.Goorantaes aro not trana&aroble G U'�C/H f 3 Gi U (i SAND 5`` +o i inoitrdMs or aubsaywnt TOWN OF $O�I'C'MO 1.O , N.Y. RAL *velem. , SEAL h4o 5 % PREMI 5E.5 ARE. Si-401.4 t.J AS Lo T 2 Ohl �,of NE1, N li .-...,\ Q• a`cK �qti O� � MINOR SUe:DIvISIOu MADE IOR KioRMAt.1 MCGULLOUGH ANO. MAP P�© : MAY S, t°fa`i , y a . G .Y^ , < t Gcar1-roURS VROM 5U Fvi-K- BOUNTY D, PUJ• G p c RODERICK VAN TUYL, P.C. t, '' �E1\I�� SLIRVV� - r r +ec f raw I /l.`. v! t .1 —"'-•-a.0 6 1 Y ..' ': O"C 'uM : MEAN SEA L-v L. LICENSED LAND SURVEYORS (?i el�s� t 2y6��/ GREENPORT NEW YORK '-- - TEUDYM POST Ne1329