HomeMy WebLinkAboutBrown, Edna 601.COFOLKcOGy,'
JUDITH T. TERRY : Z .G ; Town Hall, 53095 Main Road
TOWN CLERK : p rZP.O. Box 1179
if � Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = tO Fax (516) 765-1823
MARRIAGE OFFICER '/'fr. S �� Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER '='�/ *
FREEDOM OF INFORMATION OFFICER „,,,,0
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1215 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : STANLEY F. SKREZEC
Address 1 : 50 GULL POND LANE
City St Zip GREENPORT NY 11944
Descripton of Proposed Construction or Alteration
FILL GREASE TRAP; ADD NEW CESSPOOL; USE EXISTING POOL AS GREASE TRAP.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner BROWN, EDNA
Mailing Address 1 7005 ROUTE 25
City St Zip EAST MARION NY 11939
Property Address 1 7005 ROUTE 25
City St Zip EAST MARION NY 11939
Tax Map No. section 31 .00 block 1 lot 3.000
Cross Street ROCKY POINT ROAD
Building Permit Number Cross Reference:
Issue Date: 10/05/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
%
JUDITH T. TERRY ` ; Town Hall, 53095 Main Road
TOWN CLERK : o T P.O. Box 1179
tJ� �� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = �0 •�‘ Fax (516) 765-1823
MARRIAGE OFFICER .'' .ate �s Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER _WU it
FREEDOM OF INFORMATION OFFICER ,„i,���
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD OCT - 4694
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office -"' '' `T'
?'^l�J��'OF SOUTHOI U ._._...3
DATED: October 4, 1994
Transmitted herewith is a copy of application No. A1269 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Skrezec for Edna Brown
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 - G/
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells, buildings,
property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
y.-- / -Signatur: /
C
Date
,.-, 1
OFFICE OF THE TOWN CLERK „ ,,,,,
Town of Southold �.1'�,C, fair`'0 Application No. / �
Judith T. Terry, Town Clerk ,' 4;%
Town Hall, 53095 Main Road $ 4 Construction v
P. O. Box 1179 , = z
Southold, New York 11971 •IPyc i Alteration
Telephone ;�O �iri $10.00 - Residential d�
(516) 65-1801 'y01 - � ,, ”' $25.00 -Non-Residential
-- ...
TOWN OF SOUTHOLD
- 3 SOUTHOLD WASTEWATER DISPOSAL DISTRICT
1 ''
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE O (.t,, 19
APPLICANT NAME: S-ntAi 447 F'. s -12-6-2
APPLICANT ADDRESS: S'® G-vLC. 9an.D CM-A-6—
-2661s0) OVA' 7v I.< WV V y
SEPTIC CESSPOOL -X
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION )-7. t( /h, C 0..4
Gr e . P -Pt (.,,`.Q favki0 vtne. , `�,
COS.-sr ? rv_ -sr---421) -4"..0 td-p/ .8--iv-eA,sr Cep al 0.0-L
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: lik1 }L-S, A . (t-5(ry g , E-& k ' /
OWNER MAILING ADDRESS: --20-0S /La-0 2g---
cfr.r Mik wk ` si. Y 114'37
OWNER PROPERTY ADDRESS: S/614A.P .,4., 4-A
TELEPHONE NUMBER OF CONTACT PERSON: 1 -7 '7 — / 6 2Z
TAX MAP NO. : Section /t Block / Lot
CROSS STREET: Cocky P00-,7 f?-0A-0,
BUILDING PERMIT NUMBER CROSS REFERENCE:
OijLt
Signat r of App ican
Zd(--- ---4-(Q
RECEIVED BY/if/
/ Town Cler 's fice
DATE: / -
S
.ezr 2 �--
s
d4-1/ / 00 5
`�� 2a v 4.12. 2-S
t 01
6r rj21656-
�<<1(4 ;,v 1-1‘/;.A-
-.720
61Cc. ti
ssrcit-
Cs
FX
Ge s y,too lr