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JUDITH T. TERRY L Town Hall, 53095 Main Road
• TOWN CLERK p T P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ‘‘‘404.,. Southold, New York 11971
•� Fax (516) 765-1823
MARRIAGE OFFICER O ®� •
�yo� Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1027 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : GARY TABOR
Address 1 : 680 NAVY STREET
City St Zip ORIENT NY 11957
Descripton of Proposed Construction or Alteration
INSTALLATION OF AN 8' X' 8' LEACHING POOL TO AN EXISTING SYSTEM.
APPROVED WITH THE FOLLOWING STIPULATIONS: MAINTAIN REQURIED SCHD
DISTANCE FROM ADJACENT WELLS AND AN EXCAVATION INSPECTION IS REQUIRED.
Name Of Owner PAPISH, KENNETH
Mailing Address 1 OLE JULE LANE
City St Zip MATTITUCK NY 11952
Property Address 1 OLE JULE LANE
City St Zip MATTITUCK NY 11952
Tax Map No. section 122.00 block 5 lot 2.000
Cross Street NEW SUFFOLK AVENUE
Building Permit Number Cross Reference:
Issue Date: 8/03/93 - Judith T. Terry
Southold Town Clerk
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JUDITH T. TERRY ` Town Hall, 53095 Main Road
,, P.O. Box 1179
TOWN CLERK ® tr-rt It
REGISTRAR OF VITAL STATISTICS .�`' Southold, New York 11971
MARRIAGE OFFICER % ® C ',e1% Fax (516) 765-1823
�® �!� Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK Q j ti 1
TOWN OF SOUTHOLD JUL 1993 ;
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TO: Southold Town Building Department w.., BLoDEPT
TOWN OF OUTHOE_ 's
FROM: Linda Cooper, Southold Town Clerk's Office
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DATED: July 15, 1993
•
• Transmitted herewith is a copy of application No. A1055 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
• Gary Tabor for Kenneth Papish
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.
614,--y_.mc
Linda J•."-Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - 1�
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DISAPPROVE - /
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OFFICE OF THE TOWN CLERK
Town of Southold � - _ �� Application No. /65,5"'
Judith T. Terry, Town Clerk _
Town Hall, 53095 Main Road Construction
P. O. Box 1179 %O�
Southold, New York 11971 F' �J Alteration
Tele hone 4®1 * �`� Residential
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(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE y. 7r
APPLICANT NAME: (;-'1 ,1527 //g461-:
APPLICANT ADDRESS: to
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
5 �^�`' C�/�a' 6 Q /
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: / 1-a/1 c l j ,,� �, IS
OWNER MAILING ADDRESS: o /d Jae, k/-e./ /419-.
OWNER PROPERTY ADDRESS: 5 ,9/- ,
TELEPHONE NUMBER OF CONTACT PERSON: 3 p 6‘, 7
TAX MAP NO. : Section ,/ Z7. Block Lot,
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
•gnature of Applicant
RECEIVED BY: •
Town GleRECtIVEDrk's Office
DATE:
JULIA 1&i
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