HomeMy WebLinkAboutMajeski JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK . ® � ��, P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ofs � Fax (516) 765-1823
MARRIAGE OFFICER -- 1 -' • Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER 1 o,/�'
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. 1289 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : THOMAS J. MCCARTHY
Address 1 : P. O. BOX 62
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
NEW SANITARY SYSTEM. INSTALL NEW SEPTIC TANK AND LEACHING POOL.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SCHD ON 12/3/93.
SCHD INSPECTION REQUIRED.
Name Of Owner MAJESKI, FRANCIS AND OTHERS
Mailing Address 1 NEW SUFFOLK AVENUE
City St Zip NEW SUFFOLK NY 11956
Property Address 1 FOURTH STREET
City St Zip NEW SUFFOLK NY 11956
Tax Map No. section 117.00 block 7 lot 8.002
Cross Street KING STREET
Building Permit Number Cross Reference:
Issue Date: 2/07/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY % . .4Town Hall, 53095 Main Road
TOWN CLERK ® rrin P.O. Box 1179 ______
U \ Southold, New York 11971
REGISTRAR OF VITAL STATISTICS t Fax\1' Fax (516) 765-1823
MARRIAGE OFFICER �'` �® ��' Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER '- ',O/ Jilt fl
FREEDOM OF INFORMATION OFFICER „,f0/011°
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OFFICE OF THE TOWN CLERK 1
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TOWN OF SOUTHOLD ,i I , 1[11Ji
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TO: Southold Town Building Department BLDG.DEPT
TOWN OF SOUTHOLD
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: February 1, 1995
Transmitted herewith is a copy of application No. 1337 for a Cesspool/
Septic Tank Construction Permit submitted by:
Thomas McCarthy for Francis Majeski & others •
Please review the application and location map and advise if the project
has received Suffolk County Health Department approval and if this office
may issue the permit.
Please complete the form below and return it to me.
Thank you.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the applicati n and location map of the project cited above
and make the following re mmendations:
APPROVE
DISAPPROVE
Comments:
Signature
Dated
1 ` u
OFFICE 4OF THE TOWN CLERK ,,,'"',„
Town of Southold ,�,,t"c5\\ FOL/r4, Application No. /5-37 ' " '
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road $0'`•' • 0
Construction '
P. O. Box 1179o T Alteration
Southold, New York 11971 W , -•
Telephone ,V ' 1 %•.''' $10.00 - Residential , .i
(516) 765-1801 '."l �, ' $25.00 - Non-Residential
TOWN OF SOUTHOLD - ,
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL "
•
Permit No.
•
Fee $ /[9.M5J •:,,• '
. DATE -/'/
APPLICANT NAME: t &YM44-S -t /110(14.0-ky
APPLICANT ADDRESS: P.?;-K6a
c',1--0 r k ,JY f ( ? a-4
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION g_ (L I/
.QA,n <s,efict-gtJik_k 4- 6.0_,a,:,t Ryt-e tGL $ , -K'd 10 ' '5--1';
/4t,a. i ',6 `b I'?3
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Cer-f\ (3 1M- e k f oP-4-
OWNER MAILING ADDRESS: ni / idk 40E , :J
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OWNER PROPERTY ADDRESS: -, i IF ' 0
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TELEPHONE NUMBER OF CONTACT PERSON: ) ? r S ?IS
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TAX MAP NO. : Section 117 Block 7 Lot P ,
S 'eef - . .
CROSS STREET: kl �� •
5 ,
BUILDING PERMIT NUMBER CROSS REFERENCE:
f 1 I Ii1i ( ,
im
ignature of plicant ' - •
RECEIVED BY: , ( ' .
Own Clerk's Office , .
DATE: oZ 6
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