HomeMy WebLinkAboutZurawski (2) •
OFFICE OF THE TOWN CLERK - c�,FFULry►"
Town of Southold �� - OG
Judith T. Terry, Town Clerk .` Z -
Town Hall, 53095 Main Road
P. O. Box 1179 •:
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' • Town Hall, 53095 Main Road
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®1 ,r ► Southold, New York 11971
JUDITH T TERRY 0141°11 TELEPHONE
TOWN CLFRK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
December 22, 1986
John E. Zurawski
P.O. Box 226
New Suffolk, New York 11956
Re: Bridge Lane
Cutchogue, New York
Dear Mr. Zurawski:
Enclosed herewith is the Construction, Alteration or Modification
Permit fora 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.
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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 /ours,
eitgliel42e.,04 tosoltia 0110
Judith T. Terry
Southold Town Clerk
Enclosures (3)
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OFFICE OF THE TOWN CLERK SV�FQC/r
Town of Southold Q�®v Ce� Application No:#-/p
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Judith T. Terry, Town Clerk
Town Hall, 53095 Main Roadcri "' Construction
P. O. Box 1179
Southold, New York 11971 �!, _ Alteration
Telephone Sal [ -0® %1 Residential
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(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
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Permit No. 6770
Fee $ /6A5"
DATE / Oyez,
APPLICANT NAME: O t) E 2G/� ,,vS ,'
P.O]3 as
APPLICANT ADDRESS: kt er0 SG/// -4 //7$
SEPTIC V CESSPOOLY
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 51MW /9_.5 de"'
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS: 6&J c.�C.ti. � -
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TELEPHONE NUMBER OF CONTACT PERSON: !` � �"r 1 'e-
TAX MAP NO. : Section Block / Lo''
CROSS STREET: a�
BUILDING PERMIT NUMBER CROSS REFERENCE:
_!44,c
/ Sig igt re of Applicant
RECEIVED BY: v)tce..,_
CIVwn2effic "
e
DATE: DEQ22 Io
Town Clerk Southold
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TOWN OF SOUTHOLD i 313 west main street
a riverhead new york 11901
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