HomeMy WebLinkAboutVassallo, Sylvester ELIZABETH A.NEVILLE h`Z` y � Town Hall, 53095 Main Road
TOWN CLERK ; p .4 P.O. Box 1179
ti 2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS • v' Prt
O * Fax (516) 765-1823
MARRIAGE OFFICER N` * Q� �� Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER �iel 4 ��•,�.
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. 1821 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : EDWARD FAIVRE
Address 1 : STONERIDGE CONTRACTING
City St Zip MILLER PLACE NY 11764
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 #R10-98-0018
Name Of Owner VASSALLO, SYLVESTER & MARY
Mailing Address 1 66 HARVEST LANE
City St Zip COMMACK NY 0000
Property Address 1 FRAMVEU ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 121 .00 block 7 lot 8.000
Cross Street SOUND AVENUE
Building Permit Number Cross Reference:
Issue Date: 3/13/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
���ilii l
�o\O u FOL,�co
ELIZABETH A.NEVILLE to �` t
Town Hall, 53095 Main Road
TOWN CLERK y P.O. Box 1179
2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS v••• � Fax (516) 765-1823
MARRIAGE OFFICER � y ()'��� Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER � of
FREEDOM OF INFORMATION OFFICER ��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED:
Transmitted herewith is a copy of application No. 1895 for a Cesspool/
Septic Tank Construction Permit submitted by:
Ed Faivre. Stonerideg Contractor for Sylvester & Mary Vassallo
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:
ignaturi
3/ , 3Iq )31
Dated
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if littiritt,
(►I:I�IcI_ OF rrlh fOwr� CLERK ,►' Iq\`FOCA-
fc,w,t u( Southold 91 cQ
iiicllllt 1 . Ferry, Town Cleric
f� 'p)Z. u'�i, X1:1 nl�itllc,tlitiii Ilu• ! `S
I-own flail, !i:1095 Main Road t t' iI:,l''
E'I L�
P. O. flux 1 179 If1 •titi! ;, ('I')l'tf! (:ul,slrrlclltt. ... ._ ...
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u-. i1 i�r;ti�!i1 �J
5irtillu,lcl, New York I II)7 i )�/ Alteration
Telephone
�/ 1\ i(i. • Residential
No,► Resitio,,littl
OWN OF SOu I IHOI_I)
SOUTIHO1.I) WASIEWAF(:R DISPOSAL DISTRICT
APPLICATION
Int
CONS-I-RU(:•f ION or Al.',THAT IOri PERMIT
• SEI' ! IC TANK or c:l:SSP001.
Permit Ido.
leu $
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APPLICANT IdnML' : `
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nl'I'I.ICnId Inl)I)RI:SS:
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SEPTIC (.:Essl'OOl_
DESCRIPTION ol= PROPOSED CONST RUG! ION OR n1-.Tl Rn-I- ION
LOCATION MAI': Must he attached hereto In(c),- . pei•nill maty 1)e Issued.
• LOCATION 01.: ['IMPOSED CONS I"R1.1C;'I ION OR AI.TI RA T ION :
OWNER 0I= I'ItOPElt TY : $yLv Opel.1)/13.0,0_.A,63..5194,/...c)._:
OWNER MAII_INC; ADDRESS:
a.mmP-C d- N.y.
OWNER PROPERTY I'ROl'I_R-1•Y nl)I)RI_SS ; g
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TI:I_I:I'IIONE NUMIIER 01: cr)N'I.nc: I f'Nlts(:)N : 33/ -985_,5-_
I AX MAI' No. : Section__ Illt,t:It
CROSS STREET :
11011.1)111G PERMIT Nl)MRER CROSS R1=1-ERI:N(::I: ; r -
ae)—zrACIa -q-a _. _
Signature of nppIl'canl
RECEIVED Iay : //
Town C:(erk's elf(ic:e .
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