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Home My WebLink AboutWilcenski • 9 OFFICE OF THE TOWN CLERK 6 .c.OFUU(of Town of SoutholdQ� g G y Judith T. Terry, Town Clerk rK. Town Hall, 53095 Main Road P. 0. Box 1179 v' .,. T:},.•. .• Southold, New York 11971 a "'' - • Telephone __ * (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 86 Residential Xx Fee $ 10.00 Non-Residential Septic Cesspool XX NAME OF OWNER: Donald J. Wilcenski OWNER MAILING ADDRESS: P.O. Box 470, Main Road Cutchoque, New York 11935 OWNER PROPERTY ADDRESS: Rosewood Drive Mattituck, New York OWNER TELEPHONE NUMBER: 734-6917 (Home) 734-6366 (Business) TAX MAP NO. : Section 113 Block 2 Lot 23 CROSS STREET: Cox Neck Road TYPE OF SYSTEM: Septic Tank New Existing Cesspool XX New XX Existing Residential XX Non-Residential DATE OF PREVIOUS PUMP-OUT: N/A 00446;e4..":7°.-.00 Judith T. Terry Southold Town Cler DATE: October 9, 1986 1 1 (TOWN SEAL) OFFICE OF THE TOWN CLERK cl\TFair Town of Southold • CQ = Application No. cr6 Judith T. Terry, Town Clerk ;% /4:1 v Town Hall, 53095 Main Road Residential P. 0. Box 1179 cn ' `� Non-Residential Southold, New York 11971 Oi *�'` Telephone OI � �'�� (516) 765-1801 TOWN OF SOUTHOLD RECEIVED SOUTHOLD WASTEWATER, DISPOSAL DISTRICT OCT 091986 Town Clerk Southold APPLICATION for • OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Ra Fee $ � - DATE Qcir•) - I (Ca OWNER NAME: �� S , 1 ` ,Qv1ST../1 OWNER MAILING ADDRESS: ?,0, Lx 410 Ivy (LooJ 01 0 . I l c\`s- OWNER PROPERTY ADDRESS: �,,,5-e,‘.abr cF\ tO1 . I \ccL OWNER TELEPHONE NUMBER: -73 (9 51 7 Ch ) "73.1- 364 (gild• Zt TAX MAP NO. : Section S 1 3 Block 1- , 0 Lot 7i 3 CROSS STREET: Co 12-oilb , TYPE OF SYSTEM: Septic Tank New Existing Cesspool X New X Existing Residential y Non-Residential ILOCADATE OF PREVIOUS PUMP-OUT: 41-Pk--- LOCATION TION MAP: Must be attached hereto before permit may be issued. (Locate building and system; give north arrow and feet of distance, approximately, to building and closest road.) 1 (AtQffzet„,(2; Signa rr• of Applicant • RECEIVED BY: 41---,2(.._dc<_. 1(2 Town �Llerk's Of ice DATE: 9 , /9f6 ,�~ 4 r . . I - , , , . \ Z a(60rO 6' �� v 1/614.,, G F ., 16"•0 stk. T . w ( . • N N � L I\\ 33' 10 o_ 4 0. 679.... V t,t, i �, y kr ,oil_ 6 9�, / 3�� za10 J(Du a. Q '� L©Y �► CJ ,, a 7. 1W411 o -73 ozta f, i on.'1\51,1, +r „ m `�``' Z► ” 1610 0 .^ \ 1#. o © 33' 10 19 37 y \ 064 1 ed/r 9 i l' . ' tk, ,‘ij ! In fir C DL P i• Op i A T EUy VICES . v �C� 1/� �y The water supply and sewage disposal _ * ` system for this residence will eon- o f to the standard of the Suffolk SUFFOLK, COUNTY' DEPARTMENT OF }HEALTH S R V 'County Department of Health Services. E VECFS jFOR APPROVAL OF CONSTNUCTION OF Donald J. Wilcenski Sin ile Earrl P. O. Box 470 ° Y Re'le Gr,Py Cutchogue, New York 11935 RATE �_Z-_f— NS rEF NO f , 0 jAPPROVED----- e.ft4,4este EXPIRES TWO YEARS FATE OF APPROVAL SUR VE.Y i+OR ,OF NEW,... REFERENCE. ® eQ�® J. '�°I{�.�'G lt��l�� $l� Yo',.,.. ' ROSEWOOD ESTATES' �01T A. -"?"1-',, P/LEO JAN. 24, /969 AS MAP NO. 5240 AT MA TTl TUCK V " '4::), TOWN OF SOUTHOLD ,;, 0�4/k i IbED T®+ SUFFOLK COUNTY, N.Y. a�Eml�se�N r,rLEs��arocE COMPANY L VK SCALE + I n= 40 ' ,,<� -�: 'DONALD J. W EN►K/ f� � S 28726 �4�JULY 2,198a •�� M :. EXCAllitit 7:::4ECTIO14 Rt1111111 LAND SUNVEYOR NIS. LIC.NO.287E6 RIVENNEAB, N.Y.