HomeMy WebLinkAboutFeigelson I�����®SQFFatir
oG
ELIZABETH A. NEVILLE 1'��=*® * ; Town Hall, 53095 Main Road
TOWN CLERK o - P.O. Box 1179
y 2 $ Southold, New York 11971
REGISTRAR,OF VITAL STATISTICS
MARRIAGE OFFICER `"-:4
�, ei�, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER � �Ql �a' Fax
(631) 765-1800
FREEDOM OF INFORMATION OFFICER •_ ,•'� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 3045 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 FEIGELSON, LINDA
Mailing Address 1 400 BACK LANE
City St Zip ORIENT NY 11957
Property Address 1 400 BACK LANE
City St Zip ORIENT NY 11957 •
Tax Map No. section 71.70 block 4 lot 14.000
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 6/11/03 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
ELIZABETH A.NEVILLE ��,_*� # Town Hall, 53095 Main Road
TOWN CLERK ; y - P.O.Box 1179
b REGISTRAR OF VITAL STATISTICS Southold,New York 11971
MARRIAGE OFFICER ,L
`F �� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER !y,LQl AG ��O��I'' Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER _�/_ ,�'� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD r-- 7
'''' :,
TO: Southold Town Building Department , MAY 2 0 2��3
FROM: Linda J. Cooper, Southold Town Clerk's Office cr.. - . •,,;•.;;:,`p 1
DATED: May 20, 2003
Transmitted herewith is a copy of application No. 3169 for a Cesspool/Septic Tank
ALTERATION Permit submitted by:
Stanley Skrezec for Linda
Feigelson
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.
* * * * * * * * * * * *
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. .
-
Signature
rir Ft .2-dd 3
Dated
w
OFFICE OF THE TOWN CLERK ,,,,,,,,
Town of• Southold �i�'�� �FfUIK `.�
Judith T. Terry, Town Clerk i'p�c'J ®*t Application No.�
-7
Town Hall, 53095 Main Road 4. Construction
P. 0. Box 1179 ; o ,°cr,
Southold, New York 11971 cn � Alteration
Telephone �s ov./ $10.00 - Residential -�
(516) 765-1801 : l
,, $25.00 - Non-Residential
•
TOWN OF SOUTHOLD.
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
•
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
•
DATE /, /3
APPLICANT NAME: P/� / cf%--
APPLICANT ADDRESS: 0 l a
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSER ON,STRUCTION OR ', LTERATION
LOCATION MAP: , Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR A TERATION: •
OWNER OF PROPERTY: Lr / e ‘..re
OWNER MAILING ADDRESS: je) /i —1 4
OWNER PROPERTY ADDRESS: .5.4 ,9Ut/dc_.-
TELEPHONE NUMBER OF CONTACT PERSON: X77` /p2,2 ._
TAX MAP NO. : Section /7 Block V Lot /�
CROSS STREET: lrt1 Cdr/ jd
BUILDING PERMIT NUMBER CROSS REFERENCE:
A j__
'.nature of Ao'elicant
RECEIVED BY: /U
T wn Cle k's Office
DATE: /67/03