HomeMy WebLinkAboutLizewski, Joseph (2) JUDITH T. TERRY $ .�G Town Hall, 53095 Main Road
TOWN CLERK Z i P.O. Box 1179
REGISTRAR OF VITAL STATISTICS O " Southold, New York 1 1971
MARRIAGE OFFICER ��� 4� Telephone(516)5765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 746 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PECON I C CESSPOOL
Address 1 : P. O. BOX 972
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
ADDITION OF A NEW OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. HOLD 12'0" SEPARATION AND CALL FOR AN
EXCAVATION INSPECTION.
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: 8/02/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY TEl,_EPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OR THE TOWN CLERK
TOWN OF SOUTHOLD
To: Southold Town Code Enforcement Officer
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A767 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for 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 - ,x
DISAPPROVE -
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Date
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OFFICCOF THE TOWN CLERK ,,,'",,,,
Town of Southold .''�� �FF��K`'-
OBJ �G" Application No._��Judith T. Terry, Town Clerk �' y
Town Hall, 53095 Main Road z _
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Construction �-
P. O. Box 1179 •
Southold, New York 11971 �. '•' Alteration
Telephone _,jjy� �.0 .�' $10.00 - Residential S/
(516) 765-1801 = 1
�' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE -7/97.- /7/
APPLICANT NAME: le-C-2-32,4....'_ 6.-j--a."-fr--e
APPLICANT ADDRESS: /gd 9472-
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: Z7C L . . ,LiZ�I..,✓-2.4i4.
OWNER MAILING ADDRESS: -u-
OWNER PROPERTY ADDRESS: "4.-1-..--...-
TELEPHONE NUMBER OF CONTACT PERSON: ^ 7e.,4r
TAX MAP NO. : Section A 2 Block 2- Lot /), , /
CROSS STREET: /C.--A. �S
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signat a of Applicant
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RECEIVED BY: w
Town Clerk's Office
DATE:
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