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Home My WebLink AboutGrabowski, Victor ,0oc0F OlKcOG JUDITH T. TERRY ; y= Town Hall, 53095 Main Road TOWN CLERK p T P.O. BOX 1 179 REGISTRAR OF VITAL STATISTICS �� Southold, New York 11971 MARRIAGE OFFICER yQ Fax (516) 765-1823 't . 1D 6� ��, Fax (516) 765-1801 O. OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 977 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : VICTOR GRABOWSKI Address 1 : P. O. BOX 132 City St Zip CUTCHOGUE NY 11935 Descripton of Proposed Construction or Alteration ADDITION OF A CESSPOOL TO AN EXISTING SYSTEM. APPROVED AS SUBMITTED. HOLD 10'0" SEPARATION. EXCAVATION INSPECTION REQUIRED. CALL 765-1802 FOR AN APPOINTMENT. Name Of Owner GRABOWSKI, VICTOR Mailing Address 1 P. O. BOX 132 City St Zip CUTCHOGUE NY 11935 Property Address 1 18875 MAIN ROAD City St Zip MATTITUCK NY 11952 Tax Map No. section 108.00 block 14 lot 2.000 Cross Street WILLOW STREET Building Permit Number Cross Reference: Issue Date: 14/15/93 Judith T. Terry Southold Town Clerk I TOWN SEAL] , ....., -„,-,• „ , t, _ --_, , . 77777-0.1 /e' i7 /r,,,,,,,,,,, i, ,,,,..,... , ..,.... • X0 5 �FFOIK i' is c, = ;‘ x APR 1��3`I t... .,.•-„-..— Town Hall, 53095 Main Road JUDITH T. TERRY ,,% ...... ` ; , TOWN CLERK : p rZ i �i.n ` , P.O Box 1 179 REGISTRAR OF VITAL STATISTICS ` IP �► • Southold, New York 11971 MARRIAGE OFFICER �Q �- ��, Fax (516) 765-1823 -- 44:ol �� Telephone (516) 765-1801 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda Cooper, Southold Town Clerk's Office DATED: April 13, 1993 Transmitted herewith is a copy of application No. A1006 for an ALTERATION PERMIT for a cesspool or septic system submitted by Victor Grabowski 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 * * * * * * * * * * * * * I have reviewed the application and location map of the project listed above and make the following recommendation: APPROVE - A DISAPPROVE - COMMENTS: 49, ` -v ti .gyp Q ,....,/, A.) 52 QR.-Q.° V 02,-----A.-., ot° ' ;,- ". ,,,, e_,. - S 0oA0 ignature e,L0 Date OFFICE OF THE TOWN CLERK """'-' Town of Southold ,-'��C 00 ' 1./ Application No. /DO Judith T. Terry, Town Clerk Town Hall, 53095 Main Road G; Construction P. O. Box 1179 ��'� Alteration Southold, New York 11971 ��trs � Telephone _o��o �� $10.00 - Residential (516) 765-1801 _ 1 f �, ! $25.00 -Non-Residential •_-- ,,..I,, TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT A t9- APPLICATION N DV) for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee $/0 DATE APPLICANT NAME: Jig- '6 `� /° A 19 GU S/(/ APPLICANT ADDRESS: /r7 c4,/ / /-tL / I/0- C U"1-C.#0 G. E /(f 3� P0_ /2v gc43 SEPTIC CESSPOOL )<‘ DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION ae ,/)- LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR LTERATION: OWNER OF PROPERTY: C_ 47 /� �� c-v 5A/ ,,00 OWNER MAILING ADIl SS: / 3 2 -- f-�� G�v515/ / i/?z-• 7/9.3 OWNER PROPERTY ADDR SS. '_'_ ' 0 r- TELEPHONE NUMBER OF CONTACT PERSON: "7 3 -- 6 TAX MAP NO. : Section /Ote5 Block 45 Lot CROSS STREET: Zei//10 BUILDING PERMIT NUMBER CROSS REFERENCE: d/(7.4- / / 21't-41 Si.. ature of Applicant RECEIVED BY: L/ Town CI rk's Office "7 DATE: - 1 - P3 S +► RD UrF ab . s s N . RIG 1- 4o 0 5 kl wMf H 005 /40' 1' E 0a)g" k /77 ---5-b _. .. �' Y cOfi T 6_11_ • 4 - • 7 0-577 PGN�®o6uSK1 N3GAA ,,,, 1 357 Csi-iit6 __ _— ._ ' '' 1 �-- � #6 >Po _ _ _ .__. . ,__. _- Pool" 1 ` cv r .tom 4i /C'O ' 4t 4 ,r () C P Q © "T- c> s c F1 L E.