HomeMy WebLinkAboutMileska OFFICE OF THE TOWN CLERK c FU
Town of Southold � �o
Judith T. Terry, Town .Clerk .` r°' _,,
Town Hall, 53095 Main Road -"
P. O. Box 1179 • _
Southold, New York 11971 OSS ����•'
Telephone 01 c
(516) 765-1801 '
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 7f Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool X
PERMIT ISSUED TO:
NAME: Winds Way Building Corp.
ADDRESS: 1020 Glen Road
Southold, New York 11971
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER 0-F PROPERTY: Paul and Theresa Mileska
OWNER MAILING ADDRESS: 188 Captain Kidd Estates
Mattituck, New YOrk 11952
OWNER PROPERTY ADDRESS : E/S Marratooka Lane
Mattituck, New York
TAX MAP NO. : Section 115 Block 4 Lot 9
CROSS STREET: 295' North of New Suffolk Avenue
BUILDING PERMIT NUMBER CROSS REFERENCE: Pending
Judith T. Ter
Southold Town Clerk
DATE : November 21 , 1986 7
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u'' ' .'1�,:; � Town Hall, 53095 Main Road
P.O. Box 1 179
= (;� :b ''FC)) Southold, New York 11971
JUDITH T TERRY "*"....ori TELEPHONE
TOWN CL (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
November 21 , 1986
Winds Way Building Corp.
1020 Glen Road
Southold, New York 11971
Re: Paul and Theresa Mileska
E/S Marratooka Lane
Mattituck, New York
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 Yours,
Judith T. Terry
Southold Town Clerk
Enclosures (3)
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OFFICE OF TOE TOWN CLERK COFULAe ;"
Town of Southold �4 ,'' .,'':,74,1,,V.-
Judith
Application No. ��
Judith T. Terry, Town Clerk a. ,*Of
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Town Hall, 53095 Main Road a i: Construction z------
P.
P. 0. Box 1179 s"m �
Southold, New York 11971 ®Si K,y+� �rot� Alteration
�„� ; � Residential
Telephone ,
(516) 765-1801
Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 7,
Fee $ /0 `"---
DATE //1' CJ/ 6
APPLICANT NAME: /� Alke7A_____ to:1Z' 6i--
APPLICANT ADDRESS: `D)ro 64-),/ 47.
u-peri ice, 4/, //c )/
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
Ot-- A /31016`‘(/%1/ C.
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED COtdT
RUCTION OR ALTERATION :
OWNER OF PROPERTY: f'L. c'
Q -iv_,,,,e frIA.i (t::: ,L`p
OWNER MAILING ADDRESS: Z Ot ✓/i`� ,f l? „ L71;4(.0-1
OWNER PROPERTY ADDRESS: � f I 6*,. ,g,7; vim, ,IrgA/p.
m0-0-.•`dj A/4 ,
TELEPHONE NUMBER OF CONTACT PERSON: `7 6-4} — / 3 3,:r- -
TAX MAP NO. : Section `/c Block 41 Lot //o Cj
CROSS STREET: a 0-" it/ r "ect/ 04A/L.,,
BUILDING PERMIT NUMBER CROSS REFERENCE:
---2---2-- #/e-, /eY4-..
Signature of Applicant
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RECEIVED BY : c..dc...
' deffilfdlerl Office
DATE:
Town Clerk Southold
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SUFFOLK CO. HEALTH DEPT. APPROVAL
is � ! ; I I r- E _' i -� / H. S. NO.
' 1 i 1 It ;i t '
• STATEMENT OF INTENT
T THE WATER SUPPLY AND SEWAGE DISPOSAL
-i•O\rs,,(7'4 f(-)U,TH(.; SYSTEMS FOR THIS RESIDENCE WILL
CONFORM TO THE STANDARDS OF THE
SUFFOLK CO DEPT—OF HEALTH SERVICES.
(5)
APPLICANT
SUFFOLK COUNTY DEPT OF HEALTH
SERVICES — FOR APPROVAL OF
CONSTRUCTION ONLY
DATE•
H. S. REF. NO
APPROVED:
' I SUFFOLK CO. TAX MAP DESIGNATION:
DIST. SECT. BLOCK PCL.
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I ,-,) ! i5 F:103
i OWNERS ADDRESS:
F1 \. 32 c, .�, . i t YAi .: .i .- �._f i _• -_
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DEED: L.•5351 P. I7,
TEST HOLE STAMP
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RQPER CK VANYL, P.C. I r•- t r
LICENSED LAND SURVEYORS ••••••.;-,
GREENPORT NEW YORK