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cn ' iii " Town Hall 53095 Main Road
0 ' � P.O. Box 1 17 9
:_'� �e .`Qi Southold, New York 11971
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JUDITH T. TERRY i �
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
April 15, 1987
John Epidy
1050 Ruth Road
P.O. Box 1007
Mattituck, New York 11952
RE: Koula Epidy
Ruth Road
Mattiutck, New York
Enclosed herewith is the Construction, Alteration or Modification
Permit for a Septic Tank or Cesspool System for which you applied.
Please be advised that each owner of real property operating an
on-site sewage disposal system, such as a septic tank or cesspool must,
prior to such operation, possess in the name of the owner an Operation
Permit for the system. The Operation Permit is issued by the Town
Clerk's Office.
The fee for an Operation Permit _is ten dollars ($10.00) for
residential use and twenty-five dollars ($25.00) for non-residential.
Please have the owner complete the enclosed Application for an Operation
Permit and return it to this office along with the proper fee.
For your general information I have enclosed an Informational
Bulletin regarding the Scavenger Waste Laws adopted by the Southold
Town Board. Should you have any questions pertaining to either permits
or the Scavenger Waste Laws, please do not hesitate to contact this
office. We will be glad to assist you in any way possible.
' Very truly ours,
lootroweigiefolredos.....00
Judith T. Terry
Southold Town Clerk
Enclosures (3)
JTT/Ijc
OFFICE OF THE TOWN CLERK (c)IF
Town of Southold 0N �C�y
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road
P. 0. Box 1179
Southold, New York 11971 O41,'�l �0�
Telephone j c
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 147 Residential X
Non-Residential
Fee $ 10.00 (paid)
Septic Cesspool X
PERMIT ISSUED TO:
NAME: John Epidy
ADDRESS: 1050 Ruth Road P.O. Box 1007
Mattituck, New York 11952
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Koula Epidy
OWNER MAILING ADDRESS: 1050 Ruth Road, P.O. Box 1007
Mattituck, New York 11952
OWNER PROPERTY ADDRESS: Ruth Road
Mattituck, New York
TAX MAP NO. : Section 106 Block 5 Lot 28
CROSS STREET: Breakwater Road
BUILDING PERMIT NUMBER CROSS REFERENCE:
°irl s.
Judith T. Terry
Southold Town Clerk
DATE : April 15, 1987
(TOWN SEAL)
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� C� 1M0y � Town Hall, 53095 Main Road
s P.O. Box 728
�1 � ' Southold, New York 11971
JUDITH T.TERRY TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICEOF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Victor Lessard, Southold Town Building Department
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy of application No. 151 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by JOhn Epidy for Koula Epidy
Please review the application and location map and advise if the
project has received Suffolk County Health Department approval
and if we may issue the permit.
Please complete the form below and return it to my office.
Thank you.
eK��IG �/
Judith T. Terry
Southold Town Clerk
I have reviewed the application and location map of the project
cited above and make the following recommendation:
APPROVE - 'C
DISAPPROVE - I
u COMMENTS: q,,Q, dH� V
Signature
Ykals7
Date
OFFICE OF THE TOWN CLERK
Town of Southold
7-9
Judith T. Terry, Town Clerk Application No.
Town Hall, 53095 Main Road Construction
P. O. Box 1179
Southold, New York 11971 Alteration
Telephone 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 .$ /6
DATE 3/3 o E
APPLICANT NAME: P"i'fr EP/2)7
APPLICANT ADDRESS: ( 6 S 6 ,e,//9Act,j / -i ✓,7U, / ' //qs.
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
•
•
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: DUi(/4gp /
OWNER MAILING ADDRESS: 70.6-0 l /22. (r� 6�C /a o
/ AzX E., �
OWNER PROPERTY ADDRESS: acz,k,
TELEPHONE NUMBER OF CONTACT PERSON g—g3 5
TAX MAP NO. : Section /6 6 Block 5 Lot .„2.e9
CROSS STREET: / /i LCJ.1✓ (eb
BUILDING PERMIT NUMBER CROSS REFERENCE:
r
Ate. ..�-
�1,•�_ o A p jr-
RECEIVED BY:
REM/Mown Clerk's Office
DATE: 441 1 4 `p987
Town C"srk Southold