HomeMy WebLinkAboutSopkia (2) JUDITH T. TERRY • Town Hall, 53095 Main Road
TOWN CLERK v P.O. Box 1179
td� � Southold, New York 11971
REGISTRAR OF VITAL STATISTICS �® �. �� Fax (516) 765-1823
MARRIAGE OFFICER �_ ' r���
= Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER = 7®1 �
FREEDOM OF INFORMATION OFFICER �:�����i�i� �Irrr
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1173 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
ADDITON OF AN OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS
BUILDINGS, PROPERTY LINES, WATER BODIES AND MINIMUM OF 2' ABOVE
GROUND WATER. EXCAVATION INSPECTION REQUIRED.
Name Of Owner SOPKIA, MARILYN
Mailing Address 1 233 NORTH MOUNTAIN AVENUE
City St Zip MONTCLAIR NJ 7042
Property Address 1 PECONIC BAY BOULEVARD
City St Zip MATTITUCK NY 11952
Tax Map No. section 144.00 block 3 lot 16.000
Cross Street MARLENE LANE
Building Permit Number Cross Reference:
Issue Date: 8/01/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY ,,O - .. ; ��� ' -fir To +a 53095 Main Road
TOWN CLERK : ® ,T : ' ` ill,
O. Box 1179
tl' � B i u l� 0, New York 11971
REGISTRAR OF VITAL STATISTICS ‘`� C j
MARRIAGE OFFICER � ® o�� ` � u� � � � vi,-(516): 765-1823
RECORDS MANAGEMENT OFFICER __��®/ `����� elephone (516) 765 1801
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FREEDOM OF INFORMATION OFFICER .....'",...,,,i,11�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: July 21, 1994
Transmitted herewith is a copy of application No. A1217 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Marilyn Sopkia
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.
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - /..--"-- _ ��®®
DISAPPROVE - EXCAVATIOl''' P ON
REQUIRE t
COMMENTS: P
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Signatur- 1111F
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Date
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OFFICE OF THE TOWN CLERK ° •.,,
Town of Southold .. \\FFULx0 / a/ 7
Judith T. Terry,
Town Clerk �' �l/y�: Application No.
/ E r:
Town Hall, 53095 Main Road Z ; Construction
P. 0. Box 1179 _` 0 '
ots� "`°` - Alteration
Southold, New York 11971
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Telephone 0Q��'� $10.00 - Residential
(516) 765-1801
= 1 $25.00 -Non-Residential
• TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
•
DATE 7 /'y
APPLICAN NAME: "e-e.--Zr?
APPLICANT ADDRESS: is Y7 Z.
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CON TRUCTION OR ALTERATION
LOCATION MAP: . Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Mair:/y 4
OWNER MAILING ADDRESS: tA 3 3 /U10lfG/ Dim- -47y 19 I/ •
OWNER PROPERTY ADDRESS: 001/A--74,atat44,..
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TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section Ai c Block 3 Lot /,
OSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
X#6#'1---eh
Signature of Aplicant
RECEIVED BY:
Town Clerk's Office
DATE:
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