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HomeMy WebLinkAboutSledjeski / ,,,,,,,,,,,,, f�oft! �Q FR/4'� ,,l - G� \� LIZABETH A.NEVILLE �/ e� ��; Town Hall, 53095 Main Road TOWN CLERK 8 ` ® , P.O. Box 1179 EGISTRAR OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER # `��,1 Fax (631) 765-6145 / .ZECORDS MANAGEMENT OFFICER �,__®d � ,� V\� lTelephone (631) 765-1800 �LEEDOM OF INFORMATION OFFICER - .•ef,"I. OFFICE OF THE TOWN CLERK SOUTHOLD 1IROSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 2574 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : STANLEY SKREZEC Address 1 : 50 GULL POND LANE City St Zip GREENPORT NY 11944 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 SLEDJESKI, WALTER Mailing Address 1 7175 ROUTE 25 City St Zip EAST MARION NY 11939 Property Address 1 7175 ROUTE 25 City St Zip EAST MARION NY 11939 Tax Map No. section 31 .00 block 1 lot 4.000 Cross Street ROCKY POINT ROAD Building Permit Number Cross Reference: Issue Date: 5/01/01 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) ile 657 Cy/ • TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: April 24, 2001 Transmitted herewith is a copy of application No. 2656 for a Cesspool/Septic Tank ALTERATION Permit submitted by: Skrezec for Walter Sledjeski 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 v DISAPPROVE Comments: Maintain required setbacks from adjacent wells, buildings,property lines and water Bodies. EXCAVATION INSPECTION REQUIRED. . Signaturk 511 /6 ( Dated /// ,. O77 .:.OF THE TOWN CLERK ,,,'""" • ,;� 1 `Town of Southold ,....istFU[Ke " / Judith T. Ter,-r-y, Town• Clerk ��' �l/y=. Application No. a Co (O Town Hall, 53095 Main Road ��� Construction P. O. Box 1179 ✓ Southold, New York 11971 (11 -W $ Alteration Telephone �,��, *II. " (516) - $10.00 - Residential �- (516) 765-1801 ---.--.:4( 4 , if $25.00 -Non-Residential ~ 01' TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT ' SEPTIC TANK or CESSPOOL Permit No. Fee $ c.� • DATE 4fIL4L 4' ( el� . r APPLICANT NAME: _ - 'STA-A.)j FS 4t 7 . APPLICANT ADDRESS: --© ..L. Pcm,b ., / 6U- S t-151(fr ' SEPTIC CESSPOOL x DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION 0/1/Co / 2 A St4 .,t- Coc poo cAva /iv , R I( 11)*-d-k ucist.k 6- _ . ,, -a &A. 01/60 i N f 60-t--, IL, elr,et„) (,(Lie Arm, '' C- SPOO L 62- c..,) 4- v - c Nati 4 eceingT- cv-es rel- re,a0A,s, LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: - L.) AL,ZL�Z.. 61 fi OWNER MAILING ADDRESS: ' 11-15- kA o4-f. 2- �._ val4sctok t k -v. ILS 3 , OWNER 'PROPERTY ADDRESS: $4)14,i 4 . TELEPHONE NUMBER OF CONTACT PERSON: &f7 7— (6 1-2- TAX -ZTAX MAP NO. : Section 3 1 Block if - Lot , CROSS STREET: 111-06(14 P eia tt BUILDING PERMIT NUMBER CROSS REFERENCE: ' ALL . AL r Signa ure of pplicant RECEIVED BY: I., bij(). ---e1,--,,. ownlerk's Office DATE: -a-c• 0/ Pr'''' ' tij ''' "i 006D i ki GA4-11-&671 (fi`1440• res � c . c ,-, Cid ' tte9-t^1 'r1, 1 (.,;,e' 0 0 mss , L Z 500 t. evA) &-mrt--- c . Akmik-of\ . , , , ...Jc\. , .- .---• .,` ' • „. i t.7. if ,.. 1