HomeMy WebLinkAboutBokina • OF
ELIZABETH A.NEVILLE �� 1••• 0�: Town Hall, 53095 Main Road
TOWN CLERK ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS /fit Southold,New York 11971
MARRIAGE OFFICER aj. Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER V* O.'��®��i� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER .
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL ,PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2518 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : PECONIC CESSPOOL
Address 1 : PO BOX 972
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
ADDITION TO EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner BOKINA, JOE
Mailing Address 1 7550 BRIDGE LANE
City St Zip CUTCHOGUE NY 11935
Property Address 1 7550 BRIDGE LANE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 84.00 block 1 lot 2.000
Cross Street ROUTE 48
Building Permit Number Cross Reference:
Issue Date: 3/02/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE e,t� ' r"'T"own Hall, 53095 Main Road
TOWN CLERK 1 0 ::�J__ �._<LR �rI
CA 4 P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER ��; i. 2 2001 Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER � �� �a ���� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICERoo S °s . «z
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OFFICE OF THE TOWN CLERK ,
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: February 20, 2001
Transmitted herewith is a copy of application No. 2606 for a Cesspool/Septic Tank ALTERATION
Permit submitted by:
Peconic Cesspool for Joe Bokina
Please review the application and location map and advise if the project has received Suffolk County
Health Department approval and if this office may issue the permit.
Please complete the form below and return it to me.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments: Maintain required setbacks from adjacent wells,buildings,property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED.
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Dated
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OFFICE OFTHE TOWN CLERK ••''��FFOLK ,
TOWN OF SOUTHOLD .• �J CQG Application No. p0�
ELIZABETH A.NEVILLE,TOWN CLERK f
P.O.BOX 1179 ;� ; Construction V
SOUTHOLD,NEW YORK 11971 vrn
to • Alteration
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Telephone ,��l' $10.00 - Residential V
(631-) 765-1800 = e �'I
• $25.00 -Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE �` do/osi
APPLICANT NAME: Re-cifyz,e,..e.„
APPLICANT ADDRESS: d?d &v"71/14 `9' L
SEPTIC CESSPOOL li'
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
,(.L'c)
ALL
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: •
OWNER OF PROPERTY: C7D�-C60-12444.4_,`
OWNER MAILING ADDRESS: 755o Xe,fger 491c°(-e-,
,v Cr /1 '935'
OWNER PROPERTY ADDRESS:
re
TELEPHONE NUMBER OF CONTACT PERSON: a-9 �9iS-tr
TAX MAP NO. : Section :94 Block L Lot AZ--
CROSS
CROSS STREET: 1(1'
BUILDING PERMIT NUMBER CROSS REFERENCE:
LZ f
Signature of Applicant
RECEIVED BY: �-
Town C1= 'k's Offic:
DATE: • D' /'
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Joe Bo}cina
7550 Bridge Lane
Cutchogue
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