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Home My WebLink AboutIsaksen, Stanley Jr (2) %OF SO(/jy- ELIZABETH A.NEVILLE • �� l0 ; Town Hall, 53095 Main Road TOWN CLERK l lI t P.O. Box 1179 r. Southold, New York 11971 REGISTRAR OF VITAL STATISTICS r) MARRIAGE OFFICER COQ � Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER l �� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER =�COUn 14,�,,olesoutholdtown.northfork.net '%�... og OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 4317-R Residential X Non-Residential Fee $ 10.00 New X Existing Name Of Owner ISAKSEN JR, STANLEY & MILDRED Mailing Address 1 PO BOX 294 Mailing Address 2 City St Zip NEW SUFFOLK NY 11956-0000 Property Address 1 455 KOUROS ROAD Property Address 2 City St Zip NEW SUFFOLK NY 11956-0000 Owner Telephone No. 631-734-5835 Tax Map No. section 117.00 block 6 lot 11.002 Cross Street GRATHWOHL ROAD Issue Date: 8/03/06 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) ELIZABETH A.NEVILLE /h`t`c\v : Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR OF VITAL STATISTICS � Southold, New York 11971 MARRIAGE OFFICER : 'F 1 Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER =Al •',,'e Telephone (631) 765-1800 ng FREEDOM OF INFORMATION OFFICER - '� ' 1/•'� southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION OPERATION PERMIT CESSPOOL or SEPTIC TANK Residential @$10 or Non-Residential @ $25 Application No. If 1 Permit No. c rdMt /0/v L - Owner Name � � � 56tkS'-e 4 �y Owner Mailing Address Pd ,560C f31 Owner Property Address Y S5 1/0(1 (rOS , 0, /re ( /(r 6 Owner Telephone No. 63/ 73"/ 5 3 Tax Map No: Section // 7 Block 06 Lot 1(/ 2- Cross Street (ra u4- oh/ ,'2 Please check each that applies: New Construction Alteration to Existing System V Residential - Non-Residential NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. (Locate building and system; give north arrow and approximate distance in feet from system to building and closest road. New construction may subm- copy of survey wig S/•HD approval.) 075-zi o6 S ature of App icant r Date Received by: , 100 .0 4 SOUlyo, . ELIZABETH A.NEVILLE / ti O Town Hall, 53095 Main Road TOWN CLERK Jri[ l P.O. Box 1179 N REGISTRAR.OF VITAL STATISTICS G Q Southold, New York 11971 MARRIAGE OFFICER 1 Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER Oly �� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER = CoUIf11 1,v°1i�� southoldtown.northfork.net ... I sg OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 3453 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : STANLEY J. ISAKSEN JR. Address 1: P 0 BOX 294 City St Zip NEW SUFFOLK NY 11956 Descripton of Proposed Construction or Alteration - PRELACE EXISTING CESSPOOL WITH 8 X 12 OVER FLOW POOL -MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS, BUILDINGS, PROPERTY LINES, AND WATER BODIES. *EXCAVATION INSPECTION REQUIRED* Name Of Owner STANLET J. ISAKSEN JR. Mailing Address 1 P 0 BOX 294 City St Zip NEW SUFFOLK NY 11956 Property Address 1 455 KOUROS ROAD City St Zip NEW SUFFOKL NY 1195 Tax Map No. section 117.00 block 6 lot 11.200 Cross Street GRATHWOHL ROAD Building Permit Number Cross Reference: Issue Date: 7/19/06 El zabeth A. Neville Southold Town Clerk (TOWN SEAL) "IL ';oF soy"'_ ELIZABETH A.NEVILLE • r ��I/i`�� y�lO Town Hall, 53095 Main Road TOWN CLERK ; P.O. Box 1179 REGISTRAR.OF VITAL STATISTICSw. Nac Southold, New York 11971 MARRIAGE OFFICER G �� Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER �� p1' Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER COUNT(�`(I allsoutholdtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD July 24, 2006 Dear Sir/Madam: Enclosed herewith is the Construction, Alteration or Modification Permit for a Septic Tank/Cesspool System for which you applied. AFTER the system is installed but prior to being used, an OPERATION PERMIT IS REQUIRED. The operation Permit is issued by the Southold Town Clerk's Office. The fee is Ten Dollars ($10.00) for a residential system and twenty-five dollars ($25.00) for a non- residential system. Your check should be made payable to the "Southold Town Clerk". An application form is enclosed. Please complete the requested information and return the application, proper fee, and LOCATION MAP (map must indicate the location of the cesspool(s)/septic tank(s), giving approximate distances in feet from any buildings to the pools and distances between the pools. Should you have any questions concerning this matter, please do not hesitate to contact this office. Very truly yours, Francesca Quintieri Account Clerk Enclosures 11J °4Y Peo 4 Zolred oc.p7L-1 v 4 l ..,......._____, ) eliwi "pa le-i/icp/ ke a 6-C Sar . ,, ____'1,, .,. , -- ,), d,/,, ,,,,A4,,,e,e 6,,,-4- ',.))ti‘c Ta-tAk- Orlif j8,6:11 - r- 4 ) , , fb#1/:.., - ,) *,, - , ,..,,., --,,,, , \\, ,_ e,4.,,„ pa 4 ' '?\‘'-)\ ' -k /64446 1 .� Si:. Go,ire 5,-e.-, j6, 5'P/7 rto-srcee,,ce_ . %: ) , Al&u) J /4ky