HomeMy WebLinkAboutZurawski •
OFFICE OF THE TOWN CLERK • ic.OFOUre
Town of Southold � �G _
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road a
P. O. Box 1179 -f,Ski
Southold, New York 11971
Telephone 1 *
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
•
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 203 Residential x
Non-Residential
Fee $ 10.00 Septic X Cesspool X
NAME OF OWNER: John E. Zurawski
OWNER MAILING ADDRESS: King Street
New Suffolk, New York 11956
OWNER PROPERTY ADDRESS: Bridge Lane
Cutchogue, New York
OWNER TELEPHONE NUMBER: , 516-734-6484
TAX MAP NO. : Section 84 Block 1 Lot 6 a
CROSS STREET: County Road 48
TYPE OF SYSTEM: Septic Tank X New x Existing
Cesspool X New x Existing
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: N/A
•
Judith T. Terr
Southold Town Clerk
DATE: January 21 , 1987
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(TOWN .SEAL)
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OFFICE OF THE TOWN CLERK 2
Town of Southold Application No.
Judith T. Terry, Town Clerk Residential
Town Hall, 53095 Main Road
P. O. Box 1179 Non-Residential
Southold, New York 11971
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 0203
Fee $ /a
DATE I 1--° �7
OWNER NAME: j-4,j E keel-b S i
OWNER MAILING ADDRESS: W I A 6- s
OWNER PROPERTY ADDRESS: j.,Qlr/Z,z Z-1/J1.5
(1,7—e,y4. 6-1,e 4/
OWNER TELEPHONE NUMBER: 73 c/- CQ cIPo
TAX MAP NO. : Section SY Block / Lot
CROSS STREET: 62 .r/ Pc,/ L/
TYPE OF SYSTEM: Septic Tank New r/ Existing
Cesspool New 17- Existing
Residential V Non-Residential
DATE OF PREVIOUS PUMP-OUT:
LOCATION 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.)
Signat e of Applicant
RECEIVED B s� ��. C�
��`
own Clerk's Office
DATE: JAN 2 01987
Town Clerk Southold
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MAP OF * Q t 3T �0 * •
LOT 4 cl �_,, HENRY RAYOR
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SYLORET ESTATE p�, No. 9263 �9 s• �
AT CUTCHOGUE �sF a , ' donack associates
LAND SJ�ti
TOWN OF SOUTHOLD . 313 west main street
SUFFOLK CO,N. Y. 1riverhead , new york 11 901
FILED ,Z/N. 8,676 #6390 (516) 369-1717
Jan. 30 , 1984 Job No. 84-436
ELEVATIONS ,4 RE /NASSUMED DATUM. ' 1000 -84-01- 64 SCole: I" =401