HomeMy WebLinkAboutZervos OFFICE OF THE TOWN CLERK (/',""
Town of Southold �' -��1/
Judith T. Terry, Town Clerk \` A4-•
Town Hall, 53095 Main Road '�;
P. O. Box 1179 .un - •• \`
Southold, New York 11971G G .Ol [ � isi
Telephone ,�,
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 65 Residential g
Non-Residential
Fee $ 10.00
Septic Cesspool x
PERMIT ISSUED TO:
NAME: Constantinos Zervos
ADDRESS: P.0. Box 2035
Orient, New York 11957
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Constantinos Zervos
OWNER MAILING ADDRESS: P.O. Box 2035,
Orient, New York 11957
OWNER PROPERTY ADDRESS : Private Road off Main Road, Orient
TAX MAP NO. : Section 13 Block 2 Lot p[o 7 •
CROSS STREET: Narrow River Road
BUILDING PERMIT NUMBER CROSS REFERENCE: Pending
Judith T. Terrrp%
Southold Town Clerk
DATE: November 3, 1986
(TOWN SEAL)
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JUDITH T TERRY ��.�.,i 044° TELEPHONE
TOWN CLI.RI. (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
November 3, 1986
Constantinos Zervos
P.O. Box 2035
Orient, New York 11957
Re: Private Road off Main Road
Orient, 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 ?tours,
Judith T. Terry
Southold Town Clerk
Enclosures (3)
JTT/Ijc
OFFICE OF THE TOWN CLERK t ;y
Town of Southold /�
Judith. T. Terry, Town Clerk �' f Application No. /0
Town Hall, 53095 Main Road Construction
P. O. Box 1179
Southold, New York 11971 Alteration
Telephone Residential r�
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. t y-1_14.,7 , 5 •
Fee %6 G'
DATE 0 ,1 3 1
APPLICANT NAME: rcory nJ j► yvtD\ 2
APPLICANT ADDRESS:Po
SEPTIC CESSPOOL '7C
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
Al P co s(t)�
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 42_1 e',t, SG(J rn
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS: j' G : I /t/`)(
TELEPHONE NUMBER OF CONTACT PERSON: c 2_G
TAX MAP NO. : Section p Block d 1, Lot �� 7
CROSS STREET: C) 0
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
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