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OFFICE OF THE TOWN CLERK c0FEJL -
Town of Southold
Judith T. Terry, Town Clerk 1 .0
Town Hall, 53095 Main Road
P. O. Box 1179 • tigg •
Southold, New York 11971No-� •••
Telephone ®1 9, r
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 266 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool X
PERMIT ISSUED TO:
NAME: William J. Walters
ADDRESS: P.O. Box 181 , Westphalia Road F
Mattituck, New York 11952
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling with Cesspool System
APPROVED as per Suffolk County Health Department approval.
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Basil Katsamakis
OWNER MAILING ADDRESS: 530 East 72nd Street
New York, New York
OWNER PROPERTY ADDRESS : The Strand
East Marion, New York
TAX MAP NO. : Section 30 Block 2 Lot 83
CROSS STREET: The Long Way
BUILDING PERMIT NUMBER CROSS REFERENCE:
aro
Judith T. T y
Southold Town Clerk
DATE : December 10, 1987
(TOWN SEAL) 1
10
_ :
"4114g1 r`"'% �' Town.Hall, 53095 Main Road
F'y
lF� 5,s4c,,�t� P.O. Box 1179
,► Southold, New York 11971
JUDITH T. TERRY '4'.01;i.#'y�A
TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
December 10, 1987
William J. Walters
P.O. Box 181, Westphalia Road
Mattituck, New York 11952
Re': Basil Katsamakis
The Strand
East Marion, New York 11939
Enclosed herewith is the Construction, Alteration or Modification
Permit for -a Septic Tank or Cesspool System for which you applied.
Please be advised that each owner of real property operating an
on-site sewage disposal system, such as a septic tank or cesspool must,
prior to such operation, possess in the name of the owner an Operation
Permit for the system. The Operation Permit is issued by the Town
Clerk's Office.
The fee for an Operation Permit is ten dollars ($10.00) for
residential use and twenty-five dollars ($25. 00) for non-residential.
Please have the owner complete the enclosed Application for an Operation
Permit and return it to this office along with the proper fee.
For your general information I have enclosed an Informational
Bulletin regarding the Scavenger Waste Laws adopted by the Southold
Town Board. Should you have any questions pertaining to either permits -
or the Scavenger Waste Laws, please do not hesitate to contact this
office. We will be glad to assist you in any way possible.
Very truly /ours,
Judith T. Terry
Southold Town Clerk
Enclosures (3)
JTT/Ijc
SECOND REQUEST
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JUDITII T TERRY TOWN OF ODI IV
TowN CLERK (516)765- �_..
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD'
December 2, 1987
To: Victor Lessard, Southold Town Building Department
From: Judith T. Terry, Southold Town Clerk-
Transmitted herewith is a copy of application No. 261 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by William J. Walters for Basil Katsamakis
Please review the application and location map and advise if the
project has received Suffolk County Health Department approval
and if we may issue the permit.
Please complete the form below and return it to my office.
Thank you.
Judith T. Terry
Southold Town Clerk
* * * * * * * * *
I have reviewed the application and location map of the project
cited above and make the following recommendation:
APPROVE - X
DISAPPROVE -
COMMENTS: a� ert �Q .4, Q
•
. l_) C sem. j):2..--s-40
Signature
1'14 lad 1
Date
•
OFFICE OF THE TOWN CLERK c.j\\FFDC/`'`+
Town of Southold Application No ;(647
Judith T. Terry, Town Clerk .; ; `;
Town Hall, 53095 Main Road o t . , Construction ✓
P. O. Box 1179 �� J,
Southold, New York 11971 '4 ; ,„' Off-' Alteration
Telephone •
01 '% ' Residential
(516) 765-1801 '- Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ /p —
DATE
� II � II
APPLICANT NAME: � _ l (�vr7 ,) _ Lc)a_ +2_�S
APPLICANT ADDRESS: ()) 1 UlJ9Z:c-eFt`cd
M q
SEPTIC ZCESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
tV1Q,4)3 C `��UC.�
LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION :
OWNER OF PROPERTY: ,.Rc. 1 , ka_-1-5nmat:(3
OWNER MAILING ADDRESS: 5 30 E1 anc4. Si-r'.u-fif
Y� �w oe_tL (&f
.
OWNER PROPERTY ADDRESS: 1 he SI-rQ n r
EceS-f- MCUei a-Y)
TELEPHONE NUMBER OF CONTACT PERSON: c27E 5-
TAX MAP NO. : Section 0 Block 0 - Lot 2 3
btkkod,'v,s,ar thble k'- user+ �Ae,KS
CROSS STREET: L-CT1 �G (�C`� Ltalo ,Dc Loi- 2i
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant dcfrLl
RECEIVED BY :,� � ,-( �Ar�
” 1= tT'ownYClerk's'Office
DATE:
DEC U 2 1967
Southold Town G(erh
THE LO�1C� �Y SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES � S7-1 -7 1
,
,-.-- FOR APPROVAL OF CC�'��'°;':"'
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APPROVED
rvACAN 1 '
\-:9 PIRE.S 'O YEARS FROM DATE OF APPROVAL
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