HomeMy WebLinkAboutKitanof, Ivan I�,�loevFour
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JUDITH T.TERRY �� y< Town Hall, 53095 Main Road
TOWN CLERK ; y Z P.O. Box 1179
REGISTRAR OF VITAL STATISTICS O Southold,New York 11971
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MARRIAGE OFFICER ���� Fax(516) 765-1823
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RECORDS MANAGEMENT OFFICER (fl1 `1►a �I
Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER ,•����.11
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1786 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : RICHARD DESRAULT
Address 1 : 90 NORTH WALNUT STREET
City St Zip MASSAPEQUA NY 11758
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 #R10-97-0179
Name Of Owner KITANOF, IVAN
Mailing Address 1 83-21 262ND STREET
City St Zip FLORAL PARK NY 11004
Property Address 1 14750 SOUNDVIEW AVENUE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 50.00 block 6 lot 3.000
Cross Street LIGHTHOUSE ROAD
Building Permit Number Cross Reference:
Issue Date: 12/31/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
��-ilii 7,61P.
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JUDITH T.TERRY ,��= Town Hall, 53095 Main Road
TOWN CLERK y i % P.O. Box 1179
�� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS `0y !**�� Fax (516) 765-1823
MARRIAGE OFFICER ;. ...'lJ� a���i� Telephone(516) 765-1800
RECORDS MANAGEMENT OFFICER 1 1�t �`��
FREEDOM OF INFORMATION OFFICER „ ,1,��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: December 22, 1997
Transmitted herewith is a copy of application No. 1860 for a Cesspool/
Septic Tank Construction Permit submitted by:
Richard DesRault (Owner in Contract) Ivan Kitanof (Current owner).
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 I
DISAPPROVE
Comments:
1 ignature
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Nl[�~ <UF THE OWN CLERK
Town '/[ Southold
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Application NO.
Judith l�. Terry, Town Clerk
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Town ||o||' 53095 Main Road Conm(rucUoo
P. Dox i 179 --- -'
0. � Alteration
Southold, NewYurk | |S7l ---� - �/-
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� � Residential
Telephone ' -�'- --_'-'
(616) 765- 1001 "n/« Nuo |leo|dcnUn|
TOWN OF S0UT|K)LU
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s()UT||OLU WASTEWATER DISPOSAL D|sTR|[T
APPLICATION
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CONSTRUCTION or A|]l]RAT|0N PERMIT
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SEPT |C TANK to CESSPOOL
Permit No.
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Feu $
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APPLICANT NAME: � , »*/ �
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APPLICANT ADDRESS: / � �w� •^1t�L��
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SEPTIC CESSPOOL 1"
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DESCRPpti
IPTION OF QF P|lOP0SEU CONSTRUCTION OR ALTERATIONe.4_ &�
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LOCATION MAP: Must be ai\athmd hereto before permit may be issued.
• LOCATION OF PROPOSED CONST|(UCTION OR ALTERATION '
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OWNER OF PROPERTY : . 11.4./%1 �~- 1471/15)4 (K / 7-19P0F_,)
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OWNER MA!LING ADDRESS: _ ���� a.-�^
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SURVEY Or PROPERTY
Situated at Yurve ed byi
y
SOUr//OLD SMITH. a 'JUNO I
TOWN OF SOUTHOtO eS _. .
F Professional La ve or r
z. SUFFOLK COUNTY
NEW YORK• 120 MEDFORD AAF ' ;.>•
SCALE 1"•40' PATCHOfjUE, Ni (: �,; .
Phone 475-3199,; o ; .:z.
survey certified 10 : LOT NOS- SNOWW HEREON REFER TO %l%lA OF. ...
D.'..--
BARBARA OESRAULT woRrNf'VUOD EsTATRs AT SOuTNocb F/C60_ `,'�
RICHARD DESRAULT FEBRUARY /7, /972 AS F/LE NQ'S67S. �' "� k
8RIDGEHAMPTON NATIONAL 8AN/(
FIDELITY NATIONAL T/flE INSURANCE CO OFN.Y • 1
GOOSE TITLE AGENCY
DATES SURVEYED : OCTOBER 2/, 1997 SES -14 T
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