HomeMy WebLinkAboutBugrow, John r
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JUDITH T.TERRY _� y< Town Hall, 53095 Main Road
TOWN CLERK y = P.O. Box 1179
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i Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ma ��,�� Fax(516) ?65 1823
MARRIAGE OFFICER �� �st Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER , �►
FREEDOM OF INFORMATION OFFICER '•��� yes°�•
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1533 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : ANTHONY SILVESTRI
Address 1 : 142-29 248TH STREET
City St Zip ROSEDALE NY 11422
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. SCHD REF. #R10-96-55
Name Of Owner BUGROW, JOHN AND MADELINE
Mailing Address 1 C/O ANTHONY SILVESTRI
142-29 248TH STREET
City St Zip ROSEDALE NY 11422
Property Address 1 HARBOR LANE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 136.00 block 1 lot 15.000
Cross Street PIERCE ROAD
Building Permit Number Cross Reference:
Issue Date: 8/29/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
533
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JUDITH T.TERRY �'_� yet`� Town Hall, 53095 Main Road
TOWN CLERK % y % P.O. Box 1179
d• T i Southold, New York 11971
REGISTRAR OF VITAL STATISTICS `� *- Fax(516) 765-1823
MARRIAGE OFFICER y 1
RECORDS MANAGEMENT OFFICER .. , 1, .0 Telephone(516) 765-1800
se
FREEDOM OF INFORMATION OFFICER ,••�0
OFFICE OF THE TOWN CLERK I1 15 q I o f I'
TOWN OF SOUTHOLD
/l; 2 7 !996
TO: Southold Town Building Department
11' e ;,
�
FROM: Linda J. Cooper, Southold Town Clerk's Office . ...
DATED: August 26, 1996
Transmitted herewith is a copy of application No. 1599 for a Cesspool/
Septic Tank Construction Permit submitted by:
Anthony Silvestri for JOhn and MadPlinP Ri,grnvy •
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.
Thank you.
44(‘-1-
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE -3,�
f
Comments: &G" — - '/� _od. ° +C/ ..E'" i `°" '. �' —�49' `�
,,
791 P2‘)"..,
Signatu e.
Dat
jFFICE OF THE TOWN CLERK �•to
s'
Town of Southold gf011�(C •
Judith T. Terr Town Clerk d Qc pG Application No./.7-
Town Hall, 53095 Main Road : Construction t� ^
P. 0. Box 1179 9 a H` 1 . Alteration
ca Y.. �+ 0
Southold, New York 11971 ;h.,
Telephone : % $10.00 - Residential
(516) 765-1801 '���-I' > 0r. $25.00 - Non-Residential
•n't
TOWN OF SOUTHOLD •
SOUTIIOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for .
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE g- 2- 6 "
•
APPLICANT NAME: yl jhun
APPLICANT ADDRESS: ( Lt.).- - 25. -2-44 St . (v `J
I2_—
SEPTIC CESSPOOLV
DESCRIPTION OF PROPOSED CONSTRUCTION ( ,, ,J `
.eer
LOCATION MAP: • Must be attached hereto before permit may be issued.
LOCATION OF PRQPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY : O n C out), a)ht, J > o I A-c4c j , ij L
OWNER MAILING ADDRESS: ''70 Al rl5, !ycsrg.
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OWNER PROPERTY ADDRESS: 43uvC
H -Pita— 2- - e07-d,+zo
TELEPHONE NUMBER OF CONTACT PERSON: I\ vt-rhos1 .5lly&sa
/0 / — 30 1) 0
TAX MAP NO. : Section /3(o Block / Lot /�
CROSS STREET : —f+-_'"_ LA-n-e TIN bi P?.-er
BUILDING PERMIT NUMBER CROSS REFERENCE :
Sign ur of Applicant
•
r ' ' 411-0"4-j //v u 02i
RECEIVED
/own Clerk's Office
DATE; F 2-C! 9(
E E.5 SUFFOLK CO. HEALTH DEPT. APPRO'
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WATER SUPPLY AND SEWAGE DI OSAL SYSTEMS MUST T :,r_:ocs at nottlendr n
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' NOVEMBER 13,1995. r$
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LICENSED LAND SURVEYORS Ys.`'-<.;, o�,F
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