HomeMy WebLinkAboutSheehan, Elizabeth ` ,
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JUDITH T.TERRY t���= t%c Town Hall, 53095 Main Road
TOWN CLERK % y x ; P.O. Box 1179
L" Southold, New York 11971
REGISTRAR OF VITAL STATISTICS O� '�� Fax (516) 765-1823
MARRIAGE OFFICER y
RECORDS MANAGEMENT OFFICER -:_49.( * ��:11/ Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER ...,,, ,,o's
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1439 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : SAMUELS & STEELMAN ARCHITECTS
Address 1 : 25235 MAIN ROAD
City St Zip CUTCHOGUE NY 11935
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. #R10-65-0008
Name Of Owner SHEEHAN, ELIZABETH & ROBERT C.
Mailing Address 1 63 WEST 89TH STREET
City St Zip NEW YORK NY 10024
Property Address 1 640 PARK AVENUE
City St Zip MATTITUCK NY 11952
Tax Map No. section 123.00 block 7 lot 11 .000
Cross Street MARRATOOKA ROAD
Building Permit Number Cross Reference:
Issue Date: 2/22/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
41111
,� �o ay .
JUDITH T.TERRY t o . % Town Hall, 53095 Main Road
%TOWN CLERK t va Z t P.O.Box 1179
REGISTRAR OF VITAL STATISTICS %0 ' ' �� Southold,New York 11971
MARRIAGE OFFICER y2. 0.. / Fax(516)765-1823
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RECORDS MANAGEMENT OFFICER �: 1 � %,° _Telephone(516) 765-1800
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FREEDOM OF INFORMATION OFFICER ~.., ,��°
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OFFICE OF THE TOWN CLERK F�
TOWN OF SOUTHOLD S ' it
TO: Southold Town Building Department '..9P,§tk �
FROM: Linda J. Cooper, Southold Town Clerk's Office . :.
DATED: February 8, 1996
Transmitted herewith is a copy of application No. 1496 for a Cesspool/
Septic Tank Construction Permit submitted by:
Samuels & Steelman for Elizabeth and Robert Sheehan .
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.
,-
---x-Fie.(_i
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE ��
DISAPPROVE
Comments: yeer- 5(7.A) ".0(/ /f -As=oar;r
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Signat - /
2 a 9,6.
Dated
OFFICE OF THE TOWN CLERK F G
J( �-;,
Town of Southold
Judith T. Terry, Town Clerk
,_r-" � Application No./S .9 )
Town Hall, 53095 Main Road
Construction
P. O. Box 1179 u' �i� , to
til� '
Southold, New York 11971
•
%> ��� Alteration
Telephone �l x 7b it Residential
(516) 765- 1301 • �
Non-Residential
•
TOWN OF SOUTIIOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT •
APPLICATION
for •
CONSTRUCTION or ALTERATION PERMIT
•
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ , C»
DATE y y/5).Pr
APPLICANT NAME: `Cj •.�, e
APPLICANT ADDRESS: 2-G" 2-3 • A/ ti
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SEPTIC CESSPOOLS
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 6/ i,01E-7"
+.ter 7 c, Jr. -- ,gitJ
• OWNER MAILING ADDRESS:
•
OWNER. PROPERTY ADDRESS:
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TELEPHONE NUMBER OF CONTACT. PERSON: _
TAX MAP NO. : Section /Z-3 Block 7
Lot
. CROSS STREET: % " /"2CV •
BUILDING PERMIT NUMBER CROSS REFERENCE:..
Sign/ re of Applicant • •
RECEIVED BY:
Town Cler'ic's Office
DATE:
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FOR APPROVAL OF CONSTRUCTION OF
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0:r'i SNEtatE FAMILY RESIDENCE ONLY Sheet Title:
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