HomeMy WebLinkAboutDessimoz, Gail S
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ELIZABETH A.NEVILLE �,``1 Gym� Town Hall, 53095 Main Road
TOWN CLERK c _< P.O. Box 1179
y = Southold, New York 11971
REGISTRAR OF VITAL STATISTICS • 1.30
1I Fax (516) 765-1823
MARRIAGE OFFICER : 4.
RECORDS MANAGEMENT OFFICER ` � **s��
1 Telephone (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. 1801 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : CLIFFOR D. SCHADT
Address 1 : 2700 HARBOR LANE
City St Zip CUTCHOGUE NY 11935
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 #R10-97-0166
Name Of Owner DESSIMOZ, GAIL & RAEZ, MICHEL
Mailing Address 1 4255 HALLOCK LANE
City St Zip MATTITUCK NY 11952
Property Address 1 SOUND AVE
City St Zip MATTITUCK NY 11952
Tax Map No. section 120.00 block 3 lot 6.000
Cross Street ALDRICH LANE
Building Permit Number Cross Reference:
Issue Date: 1/29/98 'Q-/ Afl
lizabe h A. evi e
Southold Town Clerk
(TOWN SEAL)
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\15), co ••ELIZABETH A.NEVILLE I�`Z� Gym; Town Hall, 53095 Main Road
TOWN CLERK ; p .G % .. P.O. Box 1179
% y Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Fax 1 Fax(516) 765-1823
MARRIAGE OFFICER :.,RECORDS MANAGEMENT OFFICER �..*01 ��0 0Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: January 27, 1998
Transmitted herewith is a copy of application No. 1875 for a Cesspool/
Septic Tank Construction Permit submitted by:
Clifford Schadt for Gail Dessimoz & Michel Raez
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:
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Sire
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Dated
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01:1•1[E U|' ll|E lOWN CLERK
Town '.[ souUho}d
Application 110. / >�
/'.di||/ lTerry, Tnwo Clerk / ^ � ~
T'/wn Hall, 53095 Main Road Construction c~~~~
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|` U Box | 179
P. O. Alteration
Southold, New York 11871 ---
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Te}e| h000 '^/ ' Residential_�- -_'
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(516) 765- |U01 Non |{usiJ' `Un)
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TOWN OF S0UT|K)LD
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30UT||OLU WASTEWATER DISPOSAL u|ST|oCT
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CONSTRUCT ION o, ALTER ATION PERMIT
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Permit No.
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• LOCATION OF PROPOSED CON STRU[[ ION OR /\iTERATION :
OWNER OF PROPERTY : �� Y���
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TELEPHONE NUMBER ()F CuNT/\Cl" PERSON : ____RC.{�__ __ _
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LOCATED AT /t'» /re-ic � , TOWN Of .0c04177-1,04-1=7 SUFFOLK COUNTY N.rY. �,
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