HomeMy WebLinkAboutWilcenski (2) OFFICE OF THE TOWN CLERK c0FOL,j'`,'
Town of Southold
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road �
P. 0 Box 1179 hcnki .. ` �
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Southold, •New York 11971
Telephone 4q y lO,
(516) 765-1801 '
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 45 Residential xx
Non-Residential
Fee $ 10.00
Septic Cesspool XX
PERMIT ISSUED TO:
NAME: Donald J. Wilcenski
ADDRESS: P.O. Box 470, Main Road
Cutchogue, New York 11935
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
Single Family Residential Dwelling ( 2 Story)
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Donal J. Wilcenski
OWNER MAILING ADDRESS: P.O. Box 470
Cutchogue, New York 11935
OWNER PROPERTY ADDRESS : Rosewood Drive
Mattituck, New York
TAX MAP NO. : Section 113 Block 2.0 Lot 23
CROSS STREET: Cox Neck Road
BUILDING PERMIT NUMBER CROSS REFERENCE: Pending
Judith T. Ter
Southold Town Clerk
DATE : October 2, 1986
/ (TOWN SEAL)
c "" r, 3 + Town Hall, 53095 Main Road
P.O. Box 728
r, Southold, New York 11971
JUDITH T TERRY TELEPHONE
TowN CL[7R1: (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
October 2, 1986
Donald J. Wilcenski
P.O. Box 470
Cutchogue, New .York 11935
Re: Rosewood Drive
Mattituck, 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,
Judith T. Terry
Southold Town Clerk
Enclosures (3)
JTT/Ijc
OFFICE OF THE TOWN CLERK r '
Town of Southold
Judith, T. Terry, Town Clerk Application No. 5^y
Town Hall, 53095 Main Road Construction [i
P. O. Box 1179
Southold, New York 11971 Alteration
Telephone Residential
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No._ /.5—
Fee $ /O
DATE C- ',ev Z 54,
APPLICANT NAME: ] yVlcQc.f
. (./J ( kvis�
APPLICANT ADDRESS: '&)( 4:70 114 pi
/ / .V. / r9 3 s'
SEPTIC 'CESSPOOL
DESCRIPTION OF PROPO ED CONSTRUCTION O ALTERATION �7A7
a? SI,...)
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: �rov-k_
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS: /2.ey,5ee,,AA5d
TELEPHONE NUMBER OF CONTACT PERSON: 73 V— 6c.3(p ,(
TAX MAP NO. : Section ll3 Block 2. 0 Lot 23
CROSS STREET: Col( rbc f_ ,—,Q�C c, L J_
BUILDING PERMIT NUMBER CROSS REFERENCE:
t,. „
Sig t re of Applicant
RECEIVED BY: c) - .c_—
Town Cork's Office
DATE: / ! _—�•
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