HomeMy WebLinkAboutAnnunziata, Robert &j7
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P.O. Box 1179
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� ,,•' FAX(516)765-1823
JUDITH T.TERRY TELEPHONE(516)765-1801
TOWN CLERK
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 539 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : BURGER CONSTRUCTION
Address 1 : PINE TREE ROAD
City St Zip CUTCHOGUE NY 11935
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 4/27/89.
Name Of Owner ANNUNZIATA, ROBERT AND JANE
Mailing Address 1 43 SHELL BANK PLACE
City St Zip ROCKVILLE CENTRE NY 0000
Property Address 1 PRIVATE ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 108.00 block 3 lot 8.000
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 8/29/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
I''
AUG 2 51989 ; `
46 On k y Town Hall, 53095 Main Road
BLDG.DEPT Vy FR6 " �'�•�� P.O. Box 1179
TOWN OF SOUTHOLD `lf� t ��� Southold, New York 11971
JUDITH T.TERRY ��ritorf ,� TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
August 25, 1989
To: Victor Lessard, Southold Town Building Department
From: Linda Cooper, Southold Town Clerk's Office
Dated:
Transmitted herewith is a copy of application No. 553 for 'a Cesspool/
Septic Tank Construction Permit submitted by:
Burger Construction for Robert and Jane Annunziata
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: . cat al
e. (72)-2.0
.�► �.
tr.v.„
Signature
Dated
OFFICE OF THE TOWN CLERK ,cjVFOUrp;
Town of Southold Application No:-1--S- 3
Judith T. Terry, Town Clerk �. ..4
Town Hall, 53095 Main Road B1 LiwConstruction •-
P. O. Box 1179
Southold, New York 11971 ! Alteration
Telephone -_"1t '�►, 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 $ (O
DATE 2,-( Q �
APPLICANT NAME: 2 Cr't-11-' Co ti' 7-12.-tA fid
APPLICANT ADDRESS: 0
��-� ,-f-o9 . N . 1t93 -(
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
I i I L`f
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: d '� � �u,1-1A 4: T
OWNER MAILING ADDRESS f-1. GA..
�Dc-i/( LLt reg ►-r N �`
OWNER PROPERTY ADDRESS: ' c)� �
it-4A-/ n 771 cxr, Air
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TELEPHONE NUMBER OF CONTACT PERSON: 7 7, 's"--?-/ r)
TAX MAP NO. : Section / 0 Block 3 Lot P U g
CROSS STREET: M "1 IU (M e
BUILDING PERMIT NUMBER CROSS REFERENCE:
AF ,
Signature Applica
RECEIVED BY: 64c�er4,
IMICIIVID Town Clerk' e
DATE:
AUG 25"19bi
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LICENSED LAND SURVEYORS
GREENPORT NEW YORK
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