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JUDITH T. TERRY - Town Hall, 53095 Main Road
TOWN CLERK P.O.Fri ` P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
• Fax (516) 765-1823
MARRIAGE OFFICER ® ®� •
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. 978 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : STEVEN P. CIELATKA
Address 1 : 255 DELMAR DRIVE
City St Zip LAUREL NY 11948
Descripton of Proposed Construction or Alteration
REMOVE EXISTING CESSPOOL. INSTALL NEW POOL.
APPROVED AS SUBMITTED. EXCAVATION INSPECTION REQUIRED. CALL FOR AN
APPOINTMENT (765-1802).
Name Of Owner PAPPA, VINCENT & MAUREEN
Mailing Address 1 22 SOUTH KENNEDY DRIVE
City St Zip CENTEREACH NY 11720
Property Address 1 BRAY AVENUE
City St Zip LAUREL NY 11948
Tax Map No. section 126.00 block 10 lot 9.002
Cross Street PECONIC BAY BLVD.
Building Permit Number Cross Reference:
Issue Date: 4/16/93 Judith•T. Terry
Southold Town Clerk
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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK t tiP.O. Box 1179
t� % Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ,' �� Fax (516) 765-1823
MARRIAGE OFFICER �r.�
�iLi®j Cs ��® �! Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK ii F
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TOWN OF SOUTHOLD " 6, ' ` 4
t -7 337 ?,11t 1
TO: Southold Town Building Department IC:`„•t Gf, :;
FROM: Linda Cooper, Southold Town Clerk's Office ;'(:�,' io
DATED: April 16, 1993 3
Transmitted herewith is a copy of application No. A 1009 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Steven Cielatka for Vincent & Maureen Pappa
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.
ice`)
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - X
DISAPPROVE -
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COMMENTS: � ��
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•OFFJCE OF THE TOWN CLERK c,\\rrO •
Town of Southold "
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Judith T. Terry, Town Clerk - ;'rte �, ' • Application No./�D�
Town Hall, 53095 Main Road c" r�; , "" '
P. O. Box 1179 c 11- � ,}i; � Construction
Southold, New York 11971 �` � �`� Alteration
Telephone el i sP‘b t6 Residential
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(516) 765-1301
ir�
Non-Residential
•
TOWN OF SOUTHOLD
•
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
• for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
•
Fee -$
DATE b G '
APPLICANT NAME: "5-V- \/,QC) _?, Cl QACI.
• APPLICANT ADDRESS: o�`�j3 `fyy r- Ujo,
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
tPA,+NCa.a J1a �)(S�5n CQS C
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LOCATION MAP: Must be attached hereto before permit may be issued. .
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: '
Of) Cf)./k _ CLI lr1/4Q• P..".
OWNER MAILING ADDRESS: q'7 f
OWNER PROPERTY ADDRESS: Ava Lao •
TELEPHONE NUMBER OF CONTACT. PERSON: 9 55-6 G`
L�/L�i�
TAX MAP NO. : Section JaBlock
Lot
CROSS STREET: CJCC'_O. CO ba. • ,B\Va,
BUILDING PERMIT NUMBER CROSS REFERENCE:
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Signature of rA__- •
pplicant
RECEIVED BY:
T wn Clerk's Office
DATE: � r"+li - 3
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