HomeMy WebLinkAboutSkuro JUDITH T. TERRY ; ' Town Hall, 53095 Main Road
TOWN CLERK t G ` T P.O. BOX 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER .+0 . � Fax (516) 765-1823
- 11 Iro// 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. 1046 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PECONIC CESSPOOL
Address 1 : P.O. BOX 972
City St Zip ' MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration -
ADDITION OF AN OVERFLOW, CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN DISTANCE FROM ADJACENT WELLS.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner SKURO, ROSE
Mailing Address 1 305 MARLENE LANE
City St Zip MATTITUCK NY 11952
Property Address 1 305 MARLENE LANE
City St Zip MATTITUCK NY 11952
Tax Map No. section 143.00 block 3 lot 30.000
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
A91d4;;(#.4 * ---'13/47
Issue Date: 9/24/93 Judith T. Terry
Southold Town Clerk
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JUDITH T. TERRY ,% < : Town Hall, 53095 Main Road
TOWN CLERK ® T P.O. BOX 1179
REGISTRAR OF VITAL STATISTICS Cr �` Southold, New York 11971
i1' Fax (516) 765-1823
MARRIAGE OFFICER ___��®® ..e• /eel
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' �� ,�� Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK .; ,,2) ��
TOWN OF SOUTHOLD °/1=; � C�,
TO: Southold Town Building Department '�� .' �" `,.
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FROM: Linda Cooper, Southold Town Clerk's Office f�,�j4�0. Jp
DATED: September 20, 1993b ;s
Transmitted herewith is a copy of application No. A1077 for an
ALTERATION PERMIT for ,a cesspool or septic system submitted by
Peconic Cesspool for Rose Skuro .
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.
)4- /`-'-'.-
Linda J. Cooper
. * * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - L---"#. WE 100N
DISAPPROVE - * iChl5MSE009
COMMENTS: 7 • *oi/7( e.--.),
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114-0.--
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OFFICE OF THE TOWN CLERK_ „ ,,,,,,,,,,,,,,, 4
Town of 5outlioid �'�� ��FF��k�'` � Application Neiv -7-
Judith T. Terry, Town Clerk �' G
Town Hall, 53095 Main Road ;� Cons .. -
P. O. Box 1179t
Southold, New York 11971 *$� • eration
Telephone ., , ���' $10.00 - •ential
(516) 765-18011 �, $25.00 - Non-Residential
•TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
•
APPLICATION
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for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE7/19-
APPLICANT NAME:
APPLICANT ADDRESS:
2 7 ,' 7 //f rt.--
SEPTIC CESSPOOL t—
DESCRIPTION0 �0POSED CONSTRUCTIONSTRUCT ION ORALTERATION
1�/ 9 / * Y' •
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LOCATION MAP: Must be attached hereto before permit may be issued. •
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 7 4.4_01. 0” •
OWNER MAILING ADDRESS: �®5
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OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:d9Pire5 "
TAX MAP NO. : Section / Block .3 Lot Se
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Apo 'icant
RECEIVED BY: � ��[ •
Town Office '
DATE: .Y;/--,20.- 2-,3 .
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