HomeMy WebLinkAboutMajeski, Paul .0 �OfF0(,�Co
ELIZABETH A. NEVILLE Town Hall, 53095 Main Road
TOWN CLERK Z� c ri P.O. Box 1179
t y = Southold, New York 11971
REGISTRAR OF VITAL STATISTICS tkv. Fax (516) 765-1823
MARRIAGE OFFICER O 0
RECORDS MANAGEMENT OFFICER tif O' Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER l ',II•�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1941 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 WELLS,
BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION
REQUIRED.
Name Of Owner MAJESKI, PAUL AND SUSAN
Mailing Address 1 1435 BRAY AVENUE
City St Zip LAUREL NY 11948
Property Address 1 1435 BRAY AVENUE
City St Zip LAUREL NY 11948
Tax Map No. section 126.00 block 8 lot 7.000
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 10/06/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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• ELIZABETH A.NEVILLE 0�`Z y�i.
Town Hall, 53095 Main Road
TOWN CLERK i p -' , P.O. Box 1179
CO 2 Southold,New York 11971
REGISTRAR OF VITAL STATISTICS % v' ivy t
% 49, Fax Fax(516) 765-1823
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER := "1vO a�•o Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ="-1••..„°.
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: September 28, 1998
Transmitted herewith is a copy of application No. 2018 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Paul and Susan Majeski
•
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.
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Date
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OFFICE OF THE TOWN CLERKTHE TOWN CLE
No. (320/1
ELIZABETH A.NEVILLE,TOWN CLERK
P.O.BOX 1179 }� ; Construction
SOUTHOLD,NEW YORK 11971 : > >G `
9 Alteration
$10.00 - Residential v
Telephone .j �O
(516) 765-1801 _'_y�4 �,,''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 7k/g/
APPLICANT NAME: 6
APPLICANT ADDRESS: / / �t f3,'X 97Z
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONST UCTION OR ALTERATION•
OWNER OF PROPERTY: fee ,Ve.
OWNER MAILING ADDRESS: ! T c obt--c.
OWNER PROPERTY ADDRESS: �r � •
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section / ZC Block Lot 7
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Ap cant
RECEIVED BY:
Town Cler s Office
DATE: Zb
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