HomeMy WebLinkAboutGunusen, Zakarlya „ o�"SFFOL, �oG,
JUDITH T.TERRY ����� y< • Town Hall, 53095 Main Road
TOWN CLERK y i P.O. Box 1179
h'7 � Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER \**41/ Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER ` vl A001 01 Fax
(516) 765-1800
FREEDOM OF INFORMATION OFFICER .��„ .•I”
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1517 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : CHARLES HALEY & SONS
Address 1 : 263 13TH AVENUE
City St Zip WEST BABYLON NY 11704
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. #R10-96-0058
Name Of Owner GUNUSEN, ZAKARLYA
Mailing Address 1 32 COLONIAL DRIVE
City St Zip FARMINGDALE NY 0000
Property Address 1 STONY SHORE DRIVE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 52.00 block 3 lot 24.000
Cross Street BAYBERRY LANE
Building Permit Number Cross Reference:
Issue Date: 8/06/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
,o�,oFFO60
JUDITH T.TERRY ��_ y< Town Hall, 53095 Main Road
TOWN CLERK ; y = P.O. Box 1179
REGISTRAR OF VITAL STATISTICS v.et
► Southold, New York 11971
MARRIAGE OFFICER \y, 0� �' Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER l 1a��� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ,01"6
OFFICE OF THE TOWN CLERK iti
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: July 29, 1996
Transmitted herewith is a copy of application No. 1582 for a Cesspool/
Septic Tank Construction Permit submitted by:
Charley Haley & Sons for Zakarlya Gunusen •
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: a,/,(7--1;42/4.e.„1„..) LS-C4* 9,7/60 - 006--k
Signa •re
Date•
{ • l� /
OFFICE OF THE TOWN CLERK too "
Town of Southold ��,.."c� fuLA'r', Application No. /
Judith T. Terry, Town Clerk
Town Hall, 53095 ��Man Road � t � Construction
P. O. Box 1179
, Alteration
Southold, New York 11971
Tele hone �y0 Q � $10.00 - Residential L
P
�.
(516) 765-1801 �l +;, $25.00 - Non-Residential
• •• . i L
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
i
Permit No.
Fee .$
DATE /96
APPLICANT NAME: C E 1 Q-V A-CQ -! S 0„,is -
APPLICANT ADDRESS: (L'3 - fAJ (IA 816 04.. /_1 ?o Y
SEPTIC CESSPOOL X
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
C 0HS+I2 S VocA 1r40us - y o S/ " cup
.T/ *C4 o( ec,Ae-4/1-BA
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 24-K/}-/Z lit 4 - btNu S eitl
OWNER MAILING ADDRESS: ' a ! �t�N/�-,(, NI>z
OWNER PROPERTY ADDRESS: / iy ciioe '"1) (2.1 U e .
701/274.61eliP
TELEPHONE NUMBER OF CONTACT PERSON : e 8 y — 7 9 C� 9
TAX MAP NO. : Section $ Z Block Lot Q54
CROSS STREET: A `Q C— 24)-2' LSA
BUILDING PERMIT NUMBER CROSS REFERENCE:
@iv° ,/
Signa re o A. -
RECEIVED BY : Al/ //4t--1" --'
Town Clerk's Of 'ce
DATE: 7/a9
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