HomeMy WebLinkAboutPawlowski OFFICE OF THE TOWN CLERK cOFU[I(r�+
Town of Southold
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road • ofes'
P. O. Box 1179 . .tFy
Southold, New York 11971 ���
Telephone !
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR. ALTERAT ION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 209 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool x
PERMIT ISSUED TO:
NAME: Harbor Construction of Shelter Island Inc.
ADDRESS: Rt. 114, P.O. Box 457
Shelter Island, New York 11964
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling
APPROVED as submitted
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Stanley and Margaret Pawlowski
OWNER MAILING ADDRESS: P.O. Box 1311
Rocky Point, New York 11778
OWNER PROPERTY ADDRESS : Crown Land Lane
Cutchoque, New York
TAX MAP NO. : Section 102 Block ' 7 Lot 4
CROSS STREET: Spur Road
BUILDING PERMIT NUMBER CROSS REFERENCE:
Judith T. Terry
Southold Town Clerk
DATE : July 31 , 1987
(TOWN SEAL)
1
r -
' •g
o° c U -
•
•En `µ� Town Hall, 53095 Main Road
yam, ;� �++
Ks tot P.O. Box 1179
°Z I o•� Southold, New York 11971
JUDITH T. TERRY !�'�����1•04. TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
July 31, 1987 -
Harbor Construction of Shelter Island Inc.
Rt. 114 •
P.O. Box 457
Shelter Island, New York 11964
Re: Stanley and Margaret Pawlowski
Crown Land Lane
Cutchogue, 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 ($25. 00) for non-residential.
Please have the owner complete the enclosed Application for an Operation
Permit and return it to this office along with the proper fee.
For your general information I have enclosed an Informational
Bulletin regarding the Scavenger Waste Laws adopted by the Southold
Town Board. Should you have any questions pertaining to either permits
or the Scavenger Waste Laws, please do not hesitate to contact this
office. We will be glad to assist you in any way possible.
Very truly yours,
t1.001: mota4617.....
Judith T. Terry
Southold Town Clerk
Enclosures (3)
"JTT/Ijc
•� ,I III�I
OFFICE OF THE TOWN CLERK
Town of Southold 07
�
Judith T. Terry, Town ClerkyPe:g• .G Application No.
Town Hall,. 53095 Main Road ,f - ,� r'" Construction
P. O. Box 1179 . �$ Alteration
Southold, New York 11971
Telephone *0' � Residential
•
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL a
Permit No. C1 / •
Fee .$
DATE 7-80
APPLICANT NAME: T\,A{?. `lc2 ( .90-Vc v\ o� q „\c, .k-CJS?
APPLICANT ADDRESS: ' 2 - l V•Q (i c V6-7
3i\7 6(_) . 19
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION & Li)
LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ( , qi\U(n\(_ lo
OWNER MAILING ADDRESS: < /3//
(� pb I?x 11 7 7K
OWNER PROPERTY ADDRESS: c„,0 eo
/ L1e O cJ ,
TELEPHONE NUMBER OF CONTACT PERSON: 65'/6) ' 7/9 c3 O
TAX MAP NO. : Section l ®a Block 0 7 Lot ® I
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
s.
' 41” AO'
Anature o' Appli ant
RECEIVED BY:
Town Clerk's Office
DATE:
t
r .
F SUFFOLK COUNTY DEPARTM!N OF HEALTH S
a?a� 1 FOR APPROVAL OF CONSTILUCTlON ONLY
Ntitt.
___;"1„
/sem •
�IS REF. NO. 7— I« • - --
DATE
��.
0. e/ - S2 o vi,_ , �y APPROVED. .�A
,�N p �h S�, �li'V c4 ' Al
45.+, . • air...c.......--,..—
- -,41-44 A74A-47 . - . __
Oil)
, \
• ati q ,
♦ -9- I ,
v.
..x2S� -
ti y,�' SS ' aBti e� • SURVEY OF .
e �' LOT 8
s/0,, , 0, .• 0• , , � 0�1 ,°�t �`� ` " MAP OF CROWN LAND LANE ..
A / ^1 /
7" t
��' / ���A - FILED AUG. 27, 1975 'FILE NO.6289
/L
ti �� 96ti
- �'0 9�F° . - .A �716s
c. '',�4. 1, :': a. a - AT . CUTCHOGUE ;:
� ,� � ��°' ,':....,_ �� TOWN --OF �SOUTHOL1D `
./
Lp,� p , `9ti P �, ,: :•,,,..•.
t, �° SUFFOLK COUNTY N Y
..�f .. _ :��. T-I 000 --:.=:k..yl - ' ._-
• ;; II
- - ';''i', ,L.,,E: yt -
ew °<0 s'' , sv ti°` JULY 6 , 198'7 _
r / _
P��1 , - _ -7', _I. , . ''' ,!'':1-i sposof 5t74-67:1',-,:-.'''':::::,
,
,)O _\ a y6�,og
-- `:. . - once with the minimum �S i• /' • ib� • J� P.' The }nater supnsia a wi,1:7:7
l county to
_ t for this re ffoik C� � pep _
z = Prepared- in accord 6' / o emsaacds of th®
Pr® hed'b Ston
P blis Q
sesta Y _- - _ ';� ,• ;�, �Iv1 ,
Y,; s a 4 2 th
tie F I E D
ti Y CERT 1 _ of
for_ - '�r•'
ds
r D� - - nt
a O _
d
e
�� LAND do-+ted - -�,� L
S and a p a = = `• ,-
v;a roved
:: s , 2 �9 the LI A:L.S. and. 5• ./ - - LT '°L"AND TITLE
,' S r A nit. New York State Land COMM 0 N W E A N ;
.-, c) ) is.
F,L for such use by The ,1.:„:" -:_::::,:
/ . — — ` _ = =
INSURANCE COMPANY
�� , `/,/, o Title Association. / TITLE NO. 860 561 S �,
♦ ;C ;,,� * / SOUTH OLD SAVINGS BANK ; 1
STANLEY PAWLOWSKI -
N ----e... - -/ MARGARET PAWLOWSKI
-- 111,. .2:24_96— y0� N.Y. S. LIC. NO . 49668 / - - -'
p /C: �VEYORS a ENGINEERS , P. C.. • • -
E 51,6 ) '65:- .,5020 ; : = z., FsARE ss AREA = 41 580 SQ Y' •
= - -
;' trictaea trans"' FROM OinFAE 1- •FTS
P. O.-130X :909 oavai►ans ono OR FROM DATA OBTAINED MAIN ROAD - 1, - - ELEVATIONS- ARE REFERENCED TO• ;
•
AN ASSUMED DATUM -
- SOUTHOLD , N .Y. II971 - -
87 488