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HomeMy WebLinkAboutPapadopolas • OFFICE OF THE TOWN CLERK �FFOC/rre" Town of Southold Judith T. Terry, Town Clerk • Z Town Hall, 53095 Main Road • P. o. Box 1179 :cn {r` K`:'- New York 11971 O k' �O�-�••• Southold, Telephone - ZI (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 157 Residential X Non-Residential Fee $ 10.00 Septic Cesspool x PERMIT ISSUED TO: NAME: John Epidy ADDRESS: 1050 Ruth Road, P.O. Box 1007 Mattituck, New York 11952 DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION New Single Family Dwelling APPROVED as per Suffolk County Health Dept4 approval and city water. LOCATION OF PROPOSED CONSTRUCTION or ALTERATION: OWNER OF PROPERTY: Alexandra Papadopolas OWNER MAILING ADDRESS: 90-66 .53rd Avenue Elmhurst, New York 11373 OWNER PROPERTY ADDRESS : Ruth Road Mattituck, New York TAX MAP NO. : Section 106 Block 5 Lot 29 CROSS STREET: Breakwater Road BUILDING PERMIT NUMBER CROSS REFERENCE: Judith T. Terry Southold Town Clerk DATE: April 29, 1987 (TOWN SEAL) I4.0"c3q Fair t :" 'r7 Town Hall 53095 Main Road 74,11,* �'` P.O. Box 1179 ir (11 � � Southold, New York 11971 - JUDITH T. TERRY I -,,,,i ii/�' TELEPHONE TOWN CLERK (516)765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD April 29, 1987 John Epidy P.O. Box 1007 Mattituck, New York 11952 Re: Alexandra Papadopolas Ruth Road Mattituck, New York 4 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) JTT/Ijc -- 221"-°--^(j)thd-. a 7-0 ,irsiu jt � r �'• _ I `� Town Hall, 53095 Main Road x0.4 .. �•• ‘./ P.O.P.O. Box 728 ,,011 - Southold, New York 11971 �...... JUDITH T.TERRY TELEPHONE TOWN CLERK (516)765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK • TOWN OF SOUTHOLD April 10,1987 To: Victor Lessard, Southold Town Building Department From: Judith T. Terry, Southold Town Clerk Transmitted herewith is a copy of application No. 150 for a CONSTRUCTION or ALTERATION Permit for a cesspool or septic system submitted by John Epidy for Alexandra Papadopolas 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. • %.04040,47... Judith T. Terry Southold Town Clerk * * * * * - * * �e I have reviewed the application and location map of the project -cited above and make the following recommendation: APPROVE - DISAPPROVE - k -�. COMMENTS: o> c� C.�. i.J�o 1- 4147'0.-C, Scj 3 { J d4.,?-)j e-0 it6Q-ctUR #0, Signature :4/-2-8/2F7 Date ti OFFICE OF THE TOWN CLERK Town of Southold Application No. 7S7) Judith T. Terry, Town Clerk Town Hall, 53095 Main Road Construction P. 0. Box 1179 • Southold, New York 11971 Alteration Telephone 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. /6-7 Fee .$ /O DATE 330/9 APPLICANT NAME: ✓ V EP/ b ' Po k3 /007 APPLICANT ADDRESS: /e,..5-6 J/ i /j/C1ct'/ / SEPTIC V CESSPOO L DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTR CTION OR ALTS TION: OWNER OF PROPERTYA.-/f/A/AeW `" i AZ OWNER MAILING ADDRESS: qD -�� 53/eb a E ,7 (J 67 -7 OWNER PROPERTY ADDS: x`7/47✓ //Cc�C 'yix / jeaL � oro) 19T TELEPHONE NUMBER OF CONTACT PERSON 122 TAX MAP NO. : Section /06 Block 6- Lot 2, CROSS STREET: geilAidl' / , BUILDING PERMIT NUMBER CROSS REFERENCE: Ar— `u/u •atur of Ape Ica RECEIVED BY: Town Clerk's Office DATE: ; _:_ r SUFFOLK CO HEALTH DEPT APPROVAL 1 H S NO r • r ..."'7'.* • • \�s STATEMENT_OF_INTENT o PQM �,� I j THE WATER SUPPLY AND SEWAGE DISPOSAL Ct \\!;tS SYSTEMS FOR T IS RESIDENCE WILL S ) ., S 1 CONFOR T S ' N•AR• OF THE H(CYCN SUFFOLK • • HEAL ' i SERVICES. (S) /I: Ji/ - ' /ter A' 47( ' / Ad SUF t K COUNT DEg' OF HEALTH �C)F< SERVICES - FOR APPROVAL OF ' • .--.•'A"Y• '-' PA-,Jr-�l�-.)/20UL �^ CONSCONSTRUCTION ONLAD� HA �Q19 ,...f; T H S REF NO - >0 pi lAPPROVED _ / i '" , /Asp/. r. SUFFOLK,CO TAX MAP DESIGNATION. 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