HomeMy WebLinkAboutLaboda, George to'coFOLA'
JUDITH T. TERRY � Town Hall, 53095 Main Road
Z : P.O. Box 1179
TOWN CLERK IT I
REGISTRAR OF VITAL STATISTICS �� Southold, New York 11971
MARRIAGE OFFICER yO O� �, Fax (516) 765-1823
•ain Nel � Telephone (516) 765-1801
01
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1057 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PECONIC CESSPOOL
Address 1 : P. O. BOX 972
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
ADDITION OF CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, AND PROPERTY LINES. EXCAVATION INSPECTION REQUIRED.
Name Of Owner LABODA, GEORGE AND RUTH
Mailing Address 1 1815 MARLENE LANE
City St Zip MATTITUCK NY 11952
Property Address 1 1815 MARLENE LANE
City St Zip MATTITUCK NY 11952
Tax Map No. section 144.00 block 3 lot 9.000
Cross Street PECONIC BAY BLVD.
Building Permit Number Cross Reference:
Issue Date: 11/05/93 Judith T. Terry •
Southold Town Clerk
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%JUDITH T. TERRY ; t� : Town Hall, 53095 Main Road
TOWN CLERKP.O. BOx 1179
REGISTRAR OF VITAL STATISTICS . VS � Southold, New York 11971
MARRIAGE OFFICER , Fax (516) 765 1823
"�1 �1D 10:••••• Telephone Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: October 29, 1993
Transmitted herewith is a copy of application No. A1088 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for George & Ruth Laboda
•
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 - 2.---- --
EXCNATKM INVECTION
DISAPPROVE - REQUIRED
COMMENTS: C
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OFFICE OF THE TOWN CLERK ,,s" _
Town of Southold Application No." 5�,/
Judith T. Terry, Town Clerk ��' d G
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Town Hall, 53095 Main Road - Construction v
P. O. Box 1179 ; o rn �
cf, t
New York 11971 • in Alteration
Southold,
Telephone
, $10.00 - Residential
(516) 765-1801 1
- � ,, '' $25.00 - Non-Residential
, , , ,.
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE is k 13
APPLICANT NAME: K
APPLICANT ADDRESS: Ad.
SEPTIC CESSPOOL L�
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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.�.L. ��_ . _��►�
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRU TION OR ALTERATION:
OWNER OF PROPERTY: .41ytir
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OWNER MAILING ADDRESS:/c' �► 1-��
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section /O7',Y Block 3 Lot 7
CROSS STREET: ‘20kie 4�.
BUILDING PERMIT NUMBER CROSS REFERENCE:
r
'gnature of Applicant
RECEIVED BY: a, ALicds----x-r-c2--
Town Clerk's Office
DATE: / G`/) '- /f3
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