HomeMy WebLinkAboutZuhoski (4) •
OFFICE OF THE TOWN CLERK c.0Fpur ,-
Town of Southold Do 4.
Judith T. Terry, Town Clerk .`
Town Hall, 53095 Main Road ,a'
P. O. Box 1179 f . "4t ,;
Southold, New York 11971 O �O� .`,
Telephone Alt ,,,`'
(516) 765-1801 ''
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 38 Residential XX
Fee $ 10.00 Non-Residential
Septic Cesspool XX
PERMIT ISSUED TO:
NAME: JOSEPH AND SHEILA ZUHOSKI
ADDRESS: 158A OREGON ROAD
CUTCHOGUE, NEW YORK 11935
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: JOseph and Sheila Zuhoski
OWNER MAILING ADDRESS: 158A Oregon Road
Cutchogue, New York 11935
OWNER PROPERTY ADDRESS: Middle Road
Cutchogue, New York
TAX MAP NO. : Section 102 Block 1 Lot 1.2
CROSS STREET: Depot Lane and Alvahs Lane
BUILDING PERMIT NUMBER CROSS REFERENCE: Pending
Judith T. Terry
Southold Town Clerk
DATE : September 16, 1986
(TOWN SEAL)
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, ��' Town Hall, 53095 Main Road
4:„„`.4.." ' '. � .44 P.O. Box 728
N, � o, Southold, New York 11971
JUDITH T TERRY TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
September 16, 1986
Joseph, and Sheila Zuhoski
158A Oregon Road
Cutchogue,New York 11935
Re: Middle Road
Cutchogue, 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
Eig. 211 p t,
' ",,,\wFuLe .1j �'
14 SEP 9 1 1986
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P� 414
•
s` l _j �� ...._._ TOWN OF SOUTHOLD
'� 4 � Town Hall, 53095 Main Road
45;10`"kr, R Os P.O. Box 728
0 + Southold, New York 11971
JUDITH T TERRY TELEPHONE
TowN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
September 11, 1986
To: Victor Lessard, Southold Town Building Department
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy of application No. 38 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by Joseph and Sheila Zuhoski •
Please review the application and location map and advise if the
project has received Suffolk County Health Department approval
and if we may issue the permit.
Please complete the form below and return it to my office.
Thank you.
•
eleolej
4.0.4404Tee.....
Judith T. Terry
Southold Town Clerk
* * * * * * *
I have reviewed the application and location map of the project
cited above and make the following recommendation:
APPROVE -
DISAPPROVE -
COMMENTS:
Signature
Date
OFFICE OF THE TOWN CLERK
Town of Southold
Judith, T. Terry, Town Clerk Application No. 37
Town Hall, 53095 Main Road Construction r�
P. 0. 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. •
Fee .$ /a
DATE Se IS- J4 /9x6,
APPLICANT NAME: j n Sr?f. Y-- _cet(L 'C4 I Oc
APPLICANT ADDRESS: /S 19xe,664 ed,
r, ojue
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
/Yew �; �y/eate :/y duie/1cg
�J
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTS ATION:
OWNER OF PROPERTY: �S eP qC �Ap � Zu. L D c1/, '
OWNER MAILING ADDRESS: /SY4QEer-- U7/
n, ,4, 40 .et n
OWNER PROPERTY ADDRESS: 9P/rid/e ,QDc✓
7&Ad ?a p�
TELEPHONE NUMBER OF CONTACT PERSON: (-(5S6
to
TAX MAP NO. : Section /L Block / Lot /'
CROSS STREET: .,4e/O0/ Q Q/V6? X 5 L/4
BUILDING PERMIT NUMBER CROSS REFERENCE:
i/ -/dIP • /
Signature of
RECEIVED BY: G j-e Xcece-
Town CI k's Off'ce
DATE:
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• I SUFFOLK CO. HEALTH DEPT. APPROVAL
H. S. NO. C',!
I
F Pc?cPE: I-•';' .
-Vi 'Y"i.10 FOC:: 0;
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r 1 c4- �j It '
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:--- - --1 -_-� _ ' . ;,...,..4- ..--;,--- L . , JI-. ;' _- STATEMENT OF INTENT
AT THE WATER SUPPLY AND SEWAGE DISPOSAL
-r- ....I ' y-: SYSTEMS FOR THIS RESIDENCE WILL
CONFORM TO THE STANDARDS OF THE
" c.)Lrri-fO(_G, i st•\1< SUFFOLK CO. DEPT. OF HEALTH SERVICES.
• (S) .aitst,,,- rat-ei S 6,,.m{r..li.J \'L--
APPLICA T
SUFFOLK COUNTY DEPT. OF HEALTH
' SER VICES -- FOR APPROVAL OF
- CONSTRUCTION ONLY
DATE: 1 0*-i3--e3
/l � •
H. S. REF. NO. '" ' 591 ,/ A PROVED:
/
V/ 61 Vo/o ff
SUFFOLK CO. TAX MAP DESIGNATION:
DIST. SECT. 'BLOCK PCL.
1000 10 I 1./:. I
I
,/ • OWNERS ADDRESS:
, c r-e9orr C-I.
.
Curel:043ut, N.Y: l !e::.):-.)'77;
.,'/
(?e:I. -t'3-4-5 ,r"...,�)
DEED: L.6525 P.7G-1 (t..e.:;/-.,1
t•-41-;_;(1=---iQi, ::il srr. I
TEST HOLE ' STAMP
LI ••- rric)/;oft tct1+
1'AVInOOlfW AtItYAIIun UR Agonies
10 THIS SURVEY IS A VIOLATION OF
UCUON 7209 OF THE NEW YORK STATE
IpICATVN LAW. •
$atTCiIJ COPIES OF THIS SURVEY MA/NOT MARINO
loam( PB LAND PURVEYOR'S map SEAL OR
-----------G� I19ROSSED SEAL SHALL NOT RE CONSIDERED
,J ``__ ) 10 QE A VALID TRUE COPY.
• "It should be noted that since this pUARANTEES INDICATED HEREON SHALL RUN
_ property is located in an agricultural1 ONLY TO THE PERSON FOR WHOM THE scaly'
&l. 1,5'PHAND OH HIS REHAIF TO ENI
area, the possibility exists that 111® 111LE COMPANY,GOVERNMENTAL AGEK. •
water supply maycontain trace • . IENDIPIG INSTITUTION LISTED HEREON. g.-
PP Y to PR MilIGNIES OF THE LENDING IN''
amounts of pesticides and/or nitrates.
. 1° ANT
"S , >RE ,, :
NOT"" '
Special anolysis1 -1% required. Scold w
SEAL
5 ii-vevi :,-j .1 LI h 1 7, 193
RODERICK VAN TUYL,P P.C. •
i;!. V..-�._ —r:.-- 4_
LICENSED LAND SU'P""YORS
GREENPORT Ne..ra i ORK