HomeMy WebLinkAboutBurns, Margery AO ONSUFFOL4►co
ELIZABETH A.NEVILLE Town Hall, 53095 Main Road
TOWN CLERK o P.O. Box 1179
y Z $ Southold,New York 11971
REGISTRAR OF VITAL STATISTICS ‘‘%‘34 .F Fax(516)765-1823
MARRIAGE OFFICER y �'. ��� Telephone(516) 765-1800
RECORDS MANAGEMENT OFFICER : �Ql #0•0
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. 1856 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : RANDAZZO BUILDING CO. INC.
Address 1 : 127 SWAN LAKE DRIVE
City St Zip PATCHOGUE NY 11772
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-98-0058
Name Of Owner BURNS, MARGERY
Mailing Address 1 MAIN STREET
City St Zip SOUTHOLD NY 11971
Property Address 1 CEDAR DRIVE
City St Zip <elasf iv NY 11971
Tax Map No. section 22.00 block 1 lot 5.000
Cross Street SOUTHERN BLVD.
Building Permit Number Cross Reference:
Issue Date: 5/11/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
P
��o gtFFOI 4'; MAY
ELIZABETH A. NEVILLE 0�`Z` Town all, 53095 Main Road
TOWN CLERK p - ‘ P.O. Box 1179
i y c`' Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER � Tax (516) 765-1 323
RECORDS MANAGEMENT OFFICER
QN. el Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER c O! 4.0,1
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: May 30, 1998
Transmitted herewith is a copy of application No. 1930 for a Cesspool/
Septic Tank Construction Permit submitted by:
Randazzo Building Co. , Inc. for Margery Burns
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.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following %recommendations:
APPROVE
DISAPPROVE
Comments:
'gnatur
Dated
4
OFFICE OF THE TOWN CLERK W.3\7FULk ,)
JudithTT. Terryown of ouTown Clerk ge" � .' it% Application No. /9k,
Town Hall, 53095 Main Road Construction
P. O. Box 1179
Southold, New York 11971 ".. kffAlteration �,Telephone01t Residential
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE ( (gTS---
APPLICANT
NAME: RI (_0 2 C(--- G— CJ -. <
APPLICANT ADDRESS: 2 C,0/1-1k( .__A i`„- �o�
SEPTIC / CEPOOL
DESCRIPTION OF ���P,,,///ROPO D COJ^NQS�T(RUUCJTION OR ALTERATION
ON (k/--e)
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY:
OWNER MAILING ADDRESS: i'ii4-Rc_ciz ,i JR-0,
iki, max.. . ir_
OWNER PROPERTY ADDRESS: rs1- p,h,,rpj. Q
t
A , ce
TELEPHONE NUMBER OF CONTACT PERSON: I , (( h��
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TAX MAP NO. : Section i2, Block Q( Lot d
CROSS STREET: QQNT'`f-JLC 17L4. ,
BUILDING PERMIT NUMBER CROSS REFERENCE:.
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RECEIVED BY:
Town Jerk's 6tfice
DATE: 2// s/'?
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i,99'57•40"E• \ shown hereon erre from WO/observations
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W % et o t am Ian#ar NM/he STANDARDS FOR APPROVAL
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'A DISPOSAL SYSTEMS FOR SIVGLE FAARY RESCENCES
and wI'abide by Me rename set ford,/here*and on mme
permit to conslrec,
f % SURVEY OF PROPERTY
•
so• " AT EAST MARION
TOWN OF SOUTHOLD
105 s 8 e SUFF7. OLK COUNTY N.Y.
\• \ SCALE r= 30'
APRL 2 1998
PLEAS_ N0 " suFFotxcouNnDaF�nn�rr��NLTHSERVICES
Sanitary SYStrV'1.$not to be •>
placed under dn�1M8Y aroL Pa, FOR a FAMILY
or RESIDENCE
ONLY POA A
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To C.P DATE APR 4-E 1iS RBF.�1YO) �—13 g-a°SK
aa..�u' Fr' \\\\ APPROVED 7++�¢
200.00' FO MAXIMUM BEDROOMS
g7Cp p55 THREE 77.1. FROM DATE OF APPROVAL
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N/O/F MAR EXC TION INSPECTION QU J * 1
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-------ClicTHE "" P.O.ear 909
8Q.n ASSVUI �ED DA TIRE REFERENCED TO AN M. �, 1230 TRAVELER STREET
SOUTHOLD, N.Y. 11977