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ELIZABETH A. NEVILLE ������ y�; Town Hall, 53095 Main Road
TOWN CLERK o - P.O. Box 1179
ti Z
�y, �� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS V;
O Fax(631) 765-6145
MARRIAGE OFFICER �,iL ! �1
RECORDS MANAGEMENT OFFICER L--_ sr- Telephone (631) 765 1800
FREEDOM OF INFORMATION OFFICER ���
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2378 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : STANLEY SKREZEC
Address 1 : 50 GULL POND LANE
City St Zip GREENPORT NY 11944
Descripton of Proposed Construction or Alteration
ADDITION OF OVERFLOW TO EXISTING SYSTEM.
APPLICATION APPROVED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner THORP, FRANK
Mailing Address 1 PO BOX 5
City St Zip EAST MARION NY 11939
Property Address 1 180 SOUTH LANE
City St Zip EAST MARION NY 11939
Tax Map No. section 37.00 block 6 lot 1 .001
Cross Street OLD ORCHARD LANE
Building Permit Number Cross Reference:
Issue Date: 7/31/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE % _� t�; Town Hall, 53095 Main Road
TOWN CLERK C P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
G `� / Fax (631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER _y'f1p1 4*�i� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ••� ��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: August 28, 2000
Transmitted herewith is a copy of application No. 2467 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Frank Thorp, Jr. by Stanley Skrezec .
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 -
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
S' nature
Date
Ar
OFFICE OF THE TOWN CLERK
Town of Southold .0"CgFoIKt+
Judith T. Terry, Town Clerk l/ Application No. c:7--(•&7Town Hall, 5305 Main Road Construction
P. O. Box 11791=3 �,
Southold, New York 11971 ,� Alteration
Telephone = ,j► ������ $10.00 - Residential
(516) 765-1801 = "l �,, • $25.00 - Non-Residential
,,.s,,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE 11/4-1( 2-6 0-0
APPLICANT NAME: 1➢ L'f ,it_..
APPLICANT ADDRESS: c-C) LA- Ppb /�—
a' at' y. i & ? .Y9
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION (`( j ejs4,,k_c
X14 r i 1
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: \^fL 11k 1l o-re-.p"
v
OWNER MAILING ADDRESS: ( ScI AT— PO .,E ri-
c 7 kvutl l a v. I AT-Y.
OWNER PROPERTY ADDRESS: S4y4.,4"- 4-c 4 0/'t°
TELEPHONE NUMBER OF CONTACT PERSON: Z--t 2-Z
TAX MAP NO. : Section ? 7 Block Lot
CROSS STREET: OLD. Q 1•1f 4 L,J S'
BUILDING PERMIT NUMBER CROSS REFERENCE:
Sig ature of pplicant
RECEIVED BY : ())/02.2---
own Jerk's Office
DATE: Q(�
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