HomeMy WebLinkAboutAnnibell, Michael sill.
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JUDITH T. TERRY ; .4. L Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS 4
Southold, New York 11971
MARRIAGE OFFICER Va �� Fax (516) 765-1823
__��� ��� � Telephone (516) 765-1801
1
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 753 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : RANDAZZO BUILDING CO. INC.
Address 1 : 127 SWAN LAKE DRIVE
City St Zip PATCHOGUE NY 11772
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 9/10/90.
Name Of Owner ANNIBELL, MICHAEL
Mailing Address 1 1691 CLAAS AVENUE
City St Zip HOLBROOK NY 11741
Property Address 1 BRIDGE LANE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 84.00 block 4 lot 11 .000
Cross Street COUNTY RT. 48
Building Permit Number Cross Reference:
Issue Date: 9/10/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
155
Town Hall, 53095 Main Road
P.O. Box 1179
9/7 .r Southold, New York 11971
JUDITH T.TERRY TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD \v!
rb
To: Southold Town Code Enforcement Officer j Ali 2 71991
\ALFrom: Linda Cooper, Southold Town Clerk's Office L -
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Hl.�3. vii-��`
Dated: August 27, 1991 TOWN '°`' ^'!T-'O!�y
Transmitted herewith is a copy of application No. 774 for a Cesspool/
Septic Tank Construction Permit submitted by:
Randazzo Bldg. Co. Inc. for Michael Annibell •
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
%.-4..41.tAsk\
Comments: O.., �,, atijcsatLVvi Gatct at
Pr— Ak ..
RECEIVED
\(7 c...X/ Ali;v2...o 04,
SEP 06 Nal Signature
Town Clerk Southold 2.\ .k9\0\)
Dated
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OFFICE OF THE TOWN CLERK C,IFOCA-
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Town of Southold o,- ". ��
0� {
Judith T. Terry, Town Clerk �R .' . Application No.-7`"/
Town Hall, 53095 Main Road c -• ,.- 4T, ' Construction
P. O. Box 1179 cry �.i:�, "�
'•_,
Southold, New York 11971 44,�y ', Alteration
Telephone 1 . t 0 Residential
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$ /U c?u
DATE Z7 — t7/APPLICANT NAME: PFt(� `�_2,0
> co, Dc( c___,
APPLICANT ADDRESS: / 'L Z- j - A 4-761/0C4.--
// 77c.L
SEPTIC Kc CESSPOOL )
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
,c144 G-L 1 FielA 1 7
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Pt (c4- Ir �
OWNER MAILING ADDRESS: 4,611 CLAA til
OWNER PROPERTY ADDRESS: .4/o,
6,4C._
TELEPHONE NUMBER OF CONTACT PERSON: 14-7,c- G (q
TAX MAP NO. : Section_ OW Block '-t Lot P/c9. / I
_ CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:..
141
Signature of *, :Iicant
RECEIVED BY: �9Z
Reno' C erfice
DATE:
AUG 2 71991
um OW Waft
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....,.....t..ESS•POOL. . ..--:ES5f"....v.:L—• ,
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SUFFOLK CO.HEALTH DEPT.APPROVAL
....• WMLL. ! 1 _ ,
H.S. NO.
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1 '..-WaLL , T .-
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r2 A.1;÷*b 13121DGE LANE
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1- S..4272E:20.1E.: 1 24 ----.6.06 248.80 TO L.1.12.U. STATEMENT OF INTENT
I /4° THE WATER SUPPLY AND SEWAGE DISPOSAL
, MAP OF PRO P E fl-r Y SYSTEMS FOR THIS RESIDENCE WILL
-
• SURVEYED F02 CONFORM TO THE STANDARDS OF THE
. 6C SUFFOLK CE:pPT F ALTH SERVICES.
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ro ! -7 SUFFOLK COUNTY DEPT. OF HEALTH
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IS not.to be .'' 7°'AIN CQUFTSc:i4TUCT;1-41JC)EL C '------\LY. DATE: c• • 8 Q, 1 .
H.S.REF.NO.. MISSIIMIL.--7
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Placed.
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EXPIRES -1‘./40 YEAF.:..2, Fl-i!-. 1d PKII: 01: APPROVAL.
LICENSED LAND SURVEYORS '7
GREENPORT NEW YORK
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