HomeMy WebLinkAboutLizewski, Joseph ,., FFOIK�oo
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JUDITH T. TERRY : Z .4. .. Town Hall, 53095 Main Road
TOWN : p ,Zr P.O. Box 1 179
CLERK
REGISTRAR OF VITAL STATISTICS il� �` Southold, New York 11971
MARRIAGE OFFICER 0 /, Fax (516) 765-1823
',yol � %7 ��� Fax
(516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 840 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : LOSEPH LIZEWSKI
Address 1 : 320 DEPOT LANE
City St Zip CUTCHOGUE NY 11935
Descripton of Proposed Construction or Alteration
ADDITION OF ONE POOL TO EXISTING SYSTEM.
APPROVED AS SUBMITTED. HOLD TO 10' SEPARATION BETWEEN POOLS.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner LIZEWSKI, JOSEPH
Mailing Address 1 DEPOT LANE
City St Zip CUTCHOGUE NY 11935
Property Address 1 DEPOT LANE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 102.00 block 2 lot 12.001
Cross Street ROUTE 25
Building Permit Number Cross Reference:
Issue Date: 5/15/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY • Z L Town Hall, 53095 Main Road
TOWN CLERK : p T P.O. Box 1 179
tJ� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS . y ��I Fax (516) 765-1823
MARRIAGE OFFICER O 0�,�� Telephone (516) 765-1801
'a•.,..diff°��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
May 7, 1992
MAY 7 <`
To: Southold Town Code Enforcement Officer
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A864 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Joseph Lizewski
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 - D�
DISAPPROVE - ,,,,
COMMENTS: ct,o, ea ac) a. a o c�n1 %)k, gia . ',Y 'to / o/-o
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OFFICE OF THE TOWN CLERK ,,,'"""
Town of Southold41/
Judith T. Terry, Town Clerk �� �� .. w"GA% Application No. �6
Town Hall, 53095 Main Road ; Z r G Construction
P. O. Box 1179 c " a T
Alteration
Southold, New York 11971 cn - • �.`
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Telephone $10.00 - Residential
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(516) 765-1801 =��1 4 �, ' $25.00 - Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
MAY 199?
APPLICATION
Td• C1 801
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee /(,
DATE
APPLICANT NAME: .�•l tt \
L7t, ctJ f k, o S
APPLICANT ADDRESS: 3,2.0 `0 _01'f �a,,....t.
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SEPTIC CESSPOOL
DESCRIPTION? OF PROPOSED CONSTRUCTION OR ALTERATION d" t(C)ti
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
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OWNER OF PROPERTY: L c Zew s wl r e" C
OWNER MAILING ADDRESS: lit
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section /6 2 Block b 2_ Lot (2 /c I
CROSS STREET: je-__Te �?J
BUILDING PERMIT NUMBER CROSS REFERENCE:
Si na e o Applicant
RECEIVED BY: k"
Town Clerk's Office •
DATE: _-5/77 L�
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