HomeMy WebLinkAboutGontzes, William •
OFFICE OF THE TOWN CLERK �FFO •
Town of Southold &V" Urcca"
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road
P. O. l3ox 1179 011
Southold, New York 11971 O Nv. -
Telephone Ol ,r,
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. A173 Residential X
Non-Residential
Fee $ 1a.00
Septic Cesspool X
PERMIT tSSUED TO:
NAME: Chester Orlowski
ADDRESS: Main Road
Cutchogue, New York 11935
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
Replace existing pool
APPROVED -Replace existing cesspool with new precast 10' north of existing
as submitted.
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: William Gontzes
OWNER MAILING ADDRESS: 31-42 31st Street
Astoria , New York 11106
OWNER PROPERTY ADDRESS : Rocky Point Road
East Marion, New York
TAX MAP NO. : Section 21 Block 4 Lot 1
CROSS STREET: Southern Boulevard
BUILDING PERMIT NUMBER CROSS REFERENCE:
opret044;e5,67:
Judith T. Ter
Southold Town Clerk
DATE : May 29, 1987
(TOWN SEAL)
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1 � MAY 2 2190 , oft raP:.', t c,rl c i ; tr7; Town Hall, 53095 Main Road
1.1 ,4. ' "' �� P.O. Box 1179
°` 1 Southold, New York 1 1971
TOWN OF SOUTHOLD 0
JUDITH '.A..,��,,S TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
May 22, 1987
To: Victor Lessard, Southold Town Building Department
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A176 for an
ALTERATION Permit for a cesspool or septic system submitted by
Chester Orlowski for William Gontzes .
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
Clerk
* * * * * * * * * * * * *
•
I have reviewed the application and location map of the project cited
above and make the following recommendation:
APPROVE - X
DISAPPROVE -
COMMENTS:EN �t,�pQ.t. 0\ eya.0co...9 Lu.:,..irk,
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GLArek 1Y0 .
RECEIVED
MAY 2 81987 \ trt..f.k.kj,-Lcutel
Signature
Town fll.erk Southold /g 7
Date /
OFFICE OF THE TOWN CLERK ,coFUL4' ,
Town of Sy C� Application No /176
Judith T. Terry,, Town Clerk .c.
Town Hall, 53095 Main Road Construction
P. O. Box 1179 � J� Alteration
Southold, New York 11971 ,yam ��-
Telephone 6l * '1 " 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 $ /D
DATE 6-/l9 g�
APPLICANT (lichAiL.A/1)-4..."
APPLICANT ADDRESS: 1-°1 —
SEPTIC V CESSPOOL ✓-
P
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
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OWNER OF PROPERTY: �L \ q N 6'o NTt1z
OWNER MAILING ADDRESS: .3 Z _ 3 //A
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OWNER PROPERTY ADDRESS: R f,-1j,kF ►Yl -kry+, h.
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TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section 0 '2. 1 Block C? "f' Lot U '
CROSS STREET: ct
BUILDING PERMIT NUMBER CROSS REFERENCE: / 5.,c. S Z
Signature of Applicant
RECEIVED BY ' d
Ct)vttiown lerk's ffice
DATE:
WAY 211987
Town Cterk Southold
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