HomeMy WebLinkAboutWiniarz (2) Jie i,
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ri Town Hall, 53095 Main Road
ems, ®� P.O. Box 1179
v4 .�.��' Southold, New York 11971
ED JUDITH T.TERRY ��-zzii_'II, FAX(516)765-1823
TOWN CLERK TELEPHONE(516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 623 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 OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. HOLD TO FOOTAGE AS SUBMITTED. EXCAVATION
INSPECTION REQUIRED. CALL FOR INSPECTION BEFORE COVERING (765-1801 ).
Name Of Owner WINIARZ, DOROTHY AND MECISLAUS
Mailing Address 1 P. O. BOX 1425
City St Zip MATTITUCK NY 11952
Property Address 1 NEW SUFFOLK AVENUE
City St Zip MATTITUCK NY 11952
Tax Map No. section 141 .00 block 1 lot 13.001
Cross Street OLE JULE LANE
Building ,Permit Number Cross Reference:
Issue Date: 7/18/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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_� IA_ Ni\-°•,i 1 Southold, New York 11971
JUDITH T. TERRY �'�....Ar iii! TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD12) ( (r .._`� .\
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$ I
July 10, 1990 JUL I I 1990 d
BLDG. DEPT.
To: Southold Town Code Enforcement 'Officer TOWN OF SOUTHOLD_
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No.4- 638 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Winiarz
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----1A-a--4.___-
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - X
DISAPPROVE - n
COMMENTS: 14,41/1. L QQ.4L
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y''�'� Signature
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Date
OFFICE QF,THE TOWN CLERK �,,,'",,,"""',%
Town of Southold .�'� �FfOt
5 Kyo 4 Application No.t' '
Judith T. Terry, Town Clerk �' � f Gy
Town Hall, 53095 Main Road Z L Construction
P. 0. Box 1179 : v rn ; Alteration
Southold, New York 11971 •cP s
Telephone =y0,j- „Q�►•� $10.00 - Residential
(516) 765-1801 ' �l
$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,/. /9e'
APPLICANT NAME:
APPLICANT ADDRESS: 119‘.7 972--
SEPTIC CESSPOOL
DESCRIP ION OF PROPOSED CONSTRUCTION OR ALTERATION
/ -
LOCATION MAP: Must be attached hereto before permit may be issued.
/72 eish
LOCATION OF PROPOSED CONST UCT FN ,OR ALTER TION:
OWNER OF PROPERTY: � ! r111
OWNER MAILING ADDRESS: 47461-1-) 77-1-1(
;
OWNER PROPERTY ADDRESS: 'L
TELEPHONE NUMBER OF CONTACT PERSON: dif"---96/55f
TAX MAP NO. : Section /[.4 ( Block 1 Lot- / 3 ,J
CROSS STREET: .9--
BUILDING PERMIT NUMBER CROSS REFERENCE:
00;10Cc
l / /
Signa le of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
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