HomeMy WebLinkAboutSepenoski (2) 0700
,0seVJlk��i�
ce®
te
®
r Town Hall, 53095 Main Road
P.O. Box 1179
=_50/ s Southold, New York 11971
H
JUDITT.TERRY '=�:,.,, ��'` FAX(516)765-1823
TcLERx TELEPHONE(516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 611 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : JOHN A. SEPENOSKI
Address 1 : 5600 HORTONS LANE
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
ADDITION OF A NEW CESSPOOL TO ?►N EXISTING SYSTEM.
APPROVED AS SUBMITTED. EXCAVATION INSPECTION REQUIRED. CALL THE
SOUTHOLD TOWN BUILDING DEPARTMENT (765-1802) FOR AN APPOINTMENT.
Name Of Owner SEPENOSKI, JOHN A.
Mailing Address 1 5600 HORTONS LANE
City St Zip SOUTHOLD NY 11971
Property Address 1 5600 HORTONS LANE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 54.00 block 3 lot 20.000
Cross Street OLD NORTH ROAD
Building Permit Number Cross Reference:
Issue Date: 5/14/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
. .
f 6 , i
„,„„,„„,...„,.....
•
CLF
FU(�
.‘.';' ...'•.
, ,
1j5" ' J,r; � � �� Town Hall, 53095 Main Road
1..:•-4,k.---4*.;,.,- - •-0.0 Southold,
P.O. Box 1179
_ 1 '11 ��.' Southold, New York 11971
JUDITH T. TERRY
"4"-......o.����I TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD , D r ; � �
r.._
May 7, 1990
t I MAY - 71990 l
To: Southold Town Code Enforcement 'Officer 1 rrl
From: Linda J. Cooper, Southold Town Clerk's Office ' -
Transmitted herewith is a copy of application No. A625 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
John A. Sepenoski .
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 - , DC
DISAPPROVE -
COMMENTS: c� J L .
. , • ' ,
0 er",
'eke 4: . .iAL—v-i- ir • ex...t.J ,,,...-A,,, ID,
AN Signature
[�1���i s ® o WAY 11 .19 J
Date mg cs,AA,
OFFICE OF THE TOWN CLERK • '''
Town of Southold ��''e
� �C��FF��Ke' _
Q ' Application No. 6
Judith, T. Terry, Town Clerk ; G�.
Town Hall, 53095 Main Road ; Construction
P. 0. Box 1179 c •
��
Southold, New York 11971 acts Alteration
Telephone -Ate $10..00 - Residential
(516) 765-1801 _ 1 ,0' $25.00 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit$ No,
�O
Fee
DATE 5:- 7-c,
APPLICANT' NAME: J o 1.-41 S&p enoskI
APPLICANT ADDRESS: 56fla i4oc-I- n5 Lane
So LrH' o f d, N Y I N V
•
SEPTIC_ CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
neO cpm
LOCATION MAP: Must be attached hereto before permit may be issued.
•-LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: JoJ Sepenci5J0
I '
OWNER MAILING ADDRESS: 567o 140dJO_6 Leine
S0 CA-1(00 N Y 110
7/
OWNER PROPERTY ADDRESS: Same
TELEPHONE NUMBER OF CONTACT PERSON: 76:5- 665
TAX MAP NO. : Section 5-L1 Block 3 Lot c9-6
CROSS STREET: -G (
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signatur i of Applicant
RECEIVED, BY:
Town Clerk's Office
DATE: Sf 9 0
•
;h(5 P°°
f_J 1,0 Fr F'''' le
/614 Pr, et1 to Y`�D