HomeMy WebLinkAboutKoke, Margaret •
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OFFICE OF THE TOWN CLERK
Town of Southold CDS
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road
P. 0. Box 1179 �.`
Southold, New York 11971 OT- ��'
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Telephone :40 at
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPT IC TANK or CESSPOOL
Permit No. 244 Residential X
_
Non-Residential
Fee $ 10.00
Septic Cesspool X
PERMIT ISSUED TO:
NAME: Bennett Orlowski Jr.
ADDRESS: Box 297
_ • Cutchogue, New York 11935
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling with Cesspool System
APPROVED as per Suffolk County Health Departmetrt approval
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Margaret 1Coke
OWNER MAILING ADDRESS: Calves Neck Road
Southold, New York 119711
OWNER PROPERTY ADDRESS: Smithfield Park, Mailer Court
Southold, New York
TAX MAP NO. : Section 70- Block 9 Lot 40
CROSS STREET: Custer Avenue
BUILDING PERMIT NUMBER CROSS REFERENCE:
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Judith -T. Te
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Southold Town Clerk
DATE : October 30, 1987
(;(''OWN SEAL) •
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53'095ilain Road
Off' ®�►'� P.O. Box 728
o'! id. ►►►► Southold, New York 11971
JUDITH T.TERRY TELEPHONE
TOWN CLERK
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(516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
October 28, "1987
To: Victor Lessard, Southold Town Building Department
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy of application No. 249 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by Bennett Orlowski, Jr. for Margaret Koke
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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.
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e�'��ed ippe ./rte
Judith T. Terry
Southold Town Clerk
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I have reviewed the application and location map of the project
cited above and make the following recommendation:
APPROVE -
DISAPPROVE -
' COMMENTS: Q") rd-TA.S4a. 648 ^�
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Signature
Di Ai g
Date
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OFFICE OF THE TOWN CLERK c��FFO(/�'
Town of Southold ZQ�� CD� Application No.���
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road 'fir Construction
P. O. Box 1179
Southold, New York 11971 �•`, Alteration
Telephone 0l * �• ..; Residential
(516) 765-1801 ' Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $/6
DATE �D/� F/ ?
APPLICANT NAME: /5e„„ j71 a/6 aj„f/e, : .
APPLICANT ADDRESS: ape o2 9' 7
f , // 9 .Y s
SEPTIC CESSPOOL L—
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION /L4* sp, 7 4,
LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATI N:
OWNER OF PROPERTY: .s0 /571,-/ iv" P71 d -�
OWNER MAILING ADDRESS: �/l17q A/41/ `�rlc
MO,'P (IQ u.. 74- iL9 71-�i4/e•/ J. /
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 73 y 5-7./?
TAX MAP NO. : Section 70 Block �f Lot
CROSS STREET: �r�S Apr' �y7`V.6,„/ u .Q
BUILDING PERMIT NUMBER CROSS REFERENCE:
t;(tet'
Signature of Applicant
RECEIVED BY:v
Town perk's Off `
DATE: Cr*gym
/D - 02-6- � ?
OCT 2 819 7
Town Clerk Southold
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