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Cohen, Clara
/oN,S�FFO��coG. JUDITH T.TERRYy< Town Hall, 53095 Main Road TOWN CLERK ; N Z P.O. Box 1179 Southold, New York 11971 REGISTRAR OF VITAL STATISTICS • O /� MARRIAGE OFFICER y %V-60 l Fax(516) 765-1823 . RECORDS MANAGEMENT OFFICER -_ � ( * 'j dTelephone(516) 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. 1435 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : COHEN, CLARA Address 1 : EMERY, CHRISTOPHER City St Zip PARK RIDGE NJ 07656 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. #R10-95-0128 Name Of Owner COHEN, CLARA Mailing Address 1 EMERY, CHRISTPHER 3 WEILD COURT City St Zip PARK RIDGE NJ 7656 Property Address 1 2735 SOUND VIEW AVENUE City St Zip MATTITUCK NY 11952 Tax Map No. section 94.00 block 1 lot 13.000 Cross Street Building Permit Number Cross Reference: Issue Date: 1/19/96 Judith T. Terry Southold Town Clerk (TOWN SEAL) FO[�-� ,o� JUDITH T.TERRY 1 Town Hall, 53095 Main Road TOWN CLERK cce) Z P.O.Box 1179 REGISTRAR OF VITAL STATISTICS • ��, Southold,New York 11971 MARRIAGE OFFICER Wig Q��tr Fax(516)765 1823 RECORDS MANAGEMENT OFFICER -: of 4, �►a•,, Telephone(516)765-1800 FREEDOM OF INFORMATION OFFICER ����•• ,i' OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: January 11 , 1996 Transmitted herewith is a copy of application No. 1491 for a Cesspool/ Septic Tank Construction Permit submitted by: Thomas Samuels fo Samuels & Steelman Architects for Christopher Emery 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: ^' .�..4-r3 See ex,450._ 6-1,2 RECEIVED 44..„ Signatur Its f4e.l, E'Vinda / /S' 9'6 7 Pm, Det , OFFICE OF THE TOWN CLERK 8c�����(/;, Town of Southold C' Judith T. Terry, Town Clerk 6e' "f4%, Application No. /5/9/ Town Hall, 53095 Main Road a ;. $10.00 - Residential c_------- P. O. Box 1179 to ;' $25.00 - Non-Residential Southold, New York 11971 O �$ Telephone ',t I `/� (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for ©fV 5-I-- u C--A-1 o SEPTIC TANK or CESSPOOL • VL- cv S iNG2, c /_ Jc y P e4c i/u6-, Operation Permit No. Fee $ (O, 2O DATE fi /0 96 OWNER NAME: GL-/Wi- CCW,l) /ciy/l/S76/'/5 JM 'tom' OWNER MAILING ADDRESS: c3 lt', j�7 c&432- 7 /P/, 2/P , A). J , e) 762 OWNER PROPERTY ADDRESS: 0 7,_35 S2(,Vv Y/,C 4v � /,177/7e( /� ,4.2,'� OWNER TELEPHONE NUMBER: ZO/ f © 1 TAX MAP NO. : Section / Block / Lot /3 CROSS STREET: TYPE OF SYSTEM: Septic Tank New v Existing Cesspool New Existing Residential j, Non-Residential LOCATION MAP: Must be attached hereto before permit may be issued. (Locate building and system; give north arrow and feet of distance, approximately, to building and closest road.) ature of Applicant RECEIVED BY: '4% l LL/1- 0 Town Cfer 's Office , DATE: //i/ / 6 l 1 1 tit - 3 1r , i -r, -,,' £,YsrEEM a +� ` q - caA(.., Pr2E-cam TiG '"��,'c ' 1,..v 1 - '4' )4 i rl' E P L.a.AGH i r,(Gt F�2.'�i. w/ U-rug..a. 9'4' u ‘0.1 psEr. rr=i'/e0•4 1 I. 1 5-,.• H,+--►Ga foo L tY . a a # a .._.. ___• •_•_• It -re‹.- .".-)( `.,F.S . d,+T v `� kP `-r �C; N ri -��` �� \` A f'P ton I�..t� SET f7AG K 1...:,...,- ot= .4 12E,Q. -rc . G Llsia2-Ep ; t;ZA,.%c– \1 \ 'r•��( ASA 'l•�.cam F-'<_.-1 "--,:::. ' j ✓ 0 _._-- ______________----1:_______________=&'' ---7-7- LTIL,7--( \- -. • -- - ` ','--` J�+�L �- �,, ,,, . N !. .0,– —,,,,..+ uTii rr( ALL T .� Cak7)( r ," S L_J J 0 > I .. -1,,' irt c.....:.1 4 ,,, -, , ... pli r__ , _ ., i A 1 , VII . ''f'44'it.t — i . ' ffiL . ." 1 1 .:_3 -1 7.... '111,..,.11:.•''''''.; .,.'10:.1 - - -- li.t. ' N • -44.',- , --k �E 111 . t ,ij.) • -' ..... . ;.,,,,,,.:. .. ikvt rAaitii‘,.. z \\ 3 ` ..r.' • y ,� t.. I . :. 14%. A . %%et '.-1.1 .,3,•.40400011L1 11111111',"‘'t .fti,, 1; -1....., tlii . ,, ... ...ie _,.., _ . .'s.0 N\ rs LEMNitt214 ItiltiCittiti mutts p � ,4 -� C COUNTY 'll c) OEPAR ENT 'TH SERVICES "� 1 ::. �:i.: 1 OF , ,� O FOR APPA. . ROVAL OF ' N .,__�,._' SINS FAMILY RESIDEi Y `� _,,,-OAPS/ �*`• 40.°1,..,, DATE Nov 06 HS REF. Na ,� Nie.'„ or:40101111111"-E ikr6 � .rte ® • 1,... l�P•" V Z t ".,,• ', ..- ;rim. =`'' , SIRES THREE YEARS FROM DATE OF OPROVA! �` . ;* COHEN RESIDENCE , ; 2735 Sound View Avenue, Mattituck, New York r ' LETTER OF AUTHORIZATION CHRISTOPHER EMERY 3 Weild Court Park Ridge, NJ 07656 October 17, 1995 We hereby authorize Thomas C. Samuels of SAMUELS & STEELMAN ARCHITECTS to act as our agent in obtaining all permits required by SOUTHOLD TOWN, SUFFOLK COUNTY and NEW YORK STATE for the construction of our new residence at 2735 Sound View Avenue in Mattituck, NY. /0/2-/A Chripher .L. Eme Date