HomeMy WebLinkAboutHenry (2) JUDITH T.TERRY ; Town Hall,53095 Main Road
TOWN CLERK tg P.O.Box 1179
�I Southold,New York 11971
REGISTRAR OF VITAL STATISTICS 4
MARRIAGE OFFICER \ �r ®� ��� Fax(516)765-1823
RECORDS MANAGEMENT OFFICER /®d 0.21.1 Telephone(516)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. 1263 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : STANLEY F. SKREZEC
Address 1 : 50 GULL POND LANE
City St Zip GREENPORT NY 11944
Descripton of Proposed Construction or Alteration
ADDTION OF A CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION
INSPECTION REQUIRED.
Name Of Owner HENRY, PAUL M.
Mailing Address 1 68555 ROUTE 48
City St Zip GREENPORT NY 11944
Property Address 1 68555 ROUTE 48
City St Zip GREENPORT NY 11944
Tax Map No. section 33.00 block 6 lot 13.001
Cross Street MCCANN LANE
Building Permit Number Cross Reference:
Issue Date: 12/16/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY ` ® %% Town Hall, 53095 Main Road
TOWN CLERK k ear % P.O.Box 1179
REGISTRAR OF VITAL STATISTICS % � '1�,Southold,New York 11971
Fax(516)765-1823
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER ���® ED \ ',� Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER - ,,, ,,ii'
OFFICE OF THE TOWN CLERK R M _
TOWN OF SOUTHOLD rr'@I 0 U
TO: Southold Town Building Department
1�s
FROM: Linda Cooper, Southold Town Clerk's Office '`� DEC - 9 1994 ' t,,i
DATED: December 8, 1994
) L BLDG. DEPT.
TOWN OF SOUTHOLD
Transmitted herewith is a copy of application No. A1309 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Stanley Skrezec for Paul Henry .
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: 'y.
APPROVE - EXCAVAlON UUUSPE1T11O
DISAPPROVE - REQU RED
COMMENTS: Maintain required setbacks from adjacent wells, „`,'.
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
R
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DEC 1 6 1994 Sign. ure
rows Clerk southe c / 9 K
Date
SFFICE OF THE TOWN CLERK ,,,, ,
Town of Southold (0, OfUK�
Judith T. Terry, Town Clerk �' `� veAl. Application No. / 96; r
Town Hall, 53095 Main Road e= Construction
P. O. Box 1179v • • rn ; Alteration
Southold, New York 11971 . tt2
$10.00 - Residential hone
(516) 765-1801 ‘yof Q ' $25.00 - Non-Residential
,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL,
Permit No.
Fee .$
DATE , ( / g/6
APPLICANT NAME: S"-Area/ F Cs--e_
APPLICANT ADDRESS: -C-0 ,� L
ed-re-eoluguak t9Yitt
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION 06.4kAcS'
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Lr'l® gn-0JJ
OWNER MAILING ADDRESS: Sic 4-2 Y-
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: ---/ �
TAX MAP NO. : Section 7 -3 Block 5 Lot
CROSS STREET: t - C �'_ �1�/ t-4
BUILDING PERMIT NUMBER CROSS REFERENCE:
S „nature of.Appl'- anntt
RECEIVED BY: / /
Town Cler 's Office
DATE: �� —��
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