HomeMy WebLinkAboutWilcox 0 H '•>
•
JUDITH T. TERRY :. dx + �
¢� �+ Town Hall, 53095 Main Road
TOWN CLERKe= "
® z' ETI tt
P.O. Box 1179
� �'�� ¢ �' �. Southold, New York 11971
REGISTRAR OF VITAL STATISTICS cam; x4=F °"4, r' Fax (516) 765-1823
MARRIAGE OFFICER °i'= }o Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER 1 Vii!`
FREEDOM OF INFORMATION OFFICER "0~0/0-
OFFICE
0i-OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1280 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : STANLEY SKREZEC
Address 1 : 50 GULL POND LANE
City St Zip GREENPORT NY 11944
Descripton of Proposed Construction or Alteration
MOVE SYSTEM. INSTALL SEPTIC TANK AND 2 DRAINAGE RINGS
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION
INSPECTION REQUIRED.
Name Of Owner WILCOX, BERYL
Mailing Address 1 56305 NORTH ROAD (RT. 48)
City St Zip SOUTHOLD NY 11971
Property Address 1 56305 NORTH ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 44.00 block 1 lot 23.000
Cross Street ALBERTSON LANE
Building Permit Number Cross Reference:
Issue Date: 1/30/95 Judith T. Terry
Southold Town Clerk
(TQWN SEAL)
, eb - / O' 0
1 r ,, t o
JUDITH T.TERRY ,�� -t_-':,•;'=J; e '4 Town Hall,53095 Main Road
TOWN CLERK % ' '- ` -, `r ,..1' M , P.O.Box 1179
REGISTRAR OF VITAL STATISTICS `t C .4 `V 1�, Southold,New York 11971
MARRIAGE OFFICER ,- 1� Fax(516)765-1823
RECORDS MANAGEMENT OFFICER -7®4 �i��.' Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER 'W,,, ,0°
"
OFFICE OF THE TOWN CLERK 0 E l 11 I �i �,
TOWN OF SOUTHOLD f, F.- ,
TO: Southold Town Building Department I,L 12_1A. N ? 7 1995
u
FROM: Linda Cooper, Southold Town Clerk's Office !
DATED: January 27, 1995 BLDG: DEPT
2__ TOWN OF SOl9THOLI
Transmitted herewith is a copy of application No. 1327 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Stanley skrezec for Beryl Wilcox .
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 follow' g recommendation:
APPROVE - /
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
If
P
19
REQ 1" 'l .JJJJ
Signature /
JAN 3 0 1995 /
/6 (S---
Date
town Clack Southold
,OFFII&E OF THE ,TOWN CLERK ,,,'""'
__Town of Southold ''' cJ\\V • - /
Judith T. Terry, Town Clerk �' � "cl/� /Application No. /3.:P7
Town Hall, 53095 Main Road' < Construction
P. 0. Box 1179 '� ` Alteration
Southold, New York 11971 y�'c 1
Telephone -,Residential
�
(516) 765-1801 ---- (14 �, "r . ' $25.00 - Non-Residential'
TOWN OF SOUTHOLD _
SOUTHOLD WASTEWATER DISPOSAL,DISTRICT
APPLICATION'
for
CONSTRUCTION or ALTERATION PERMIT
•
SEPTIC TANK or CESSPOOL -
•
Permit No.
Fee •$
DATE / ( -
APPLICANT NAME: eyL L. ��'�p !(.�� l► I[' -2ac
APPLICANT ADDRESS: ® &VLL.
���L !1 g51 f
SEPTICSSPOOL (�
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION G#49ive,„
•
e,0 (+ L • i9 i6C c; trus�cF-
0 tea• V,,-(9s,
LOCATION MAP: Must be attached hereto before permit may be issued. _
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: IE-re ]/L, Le0x
• OWNER MAILING ADDRESS: 56
®v-r-Vve« / N Yo,z[c 4 9 1 1
OWNER PROPERTY ADDRESS: S PZLC c� ' S A-B
TELEPHONE NUMBER OF CONTACT PERSON: L177 - )
TAX MAP NO. : Section Block ( Lot
CROSS STREET: , L ' Z2l So•�
BUILDING PERMIT NUMBER CROSS REFERENCE:
Oku-Se
S[gnature of A licant
(Afi-/Q-4-A-'`RECEIVED BY: -
Town Clerk's Office
DATE:
- - r
/ - Jai., :
n
py....,,ai-- czarel /As-14
' 1 , roijp _ ,iiim 4,-J2.,
d .,__ 6.,:04. fikcec-A14 -Q',Srose/s /-1---------------7
0
T--------", k; , Ica X
V C
l
L b ,. 1/v
e- . 1/ Wt)I 1
1 i'.�
1,
�
Vfv L
114'1 q Jo , '\ --‘-'‘(')—'3'—>
jrQr
.O‘.^