HomeMy WebLinkAboutBifulco, James ,0°A�S�FFO(�44o
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JUDITH T.TERRYo= - Town Hall,53095 Main Road
TOWN CLERK t ti Z ; P.O.Box 1179
REGISTRAR OF VITAL STATISTICS ; 411/ Southold,New York 11971
MARRIAGE OFFICER ` ifJ aQ '� Fax(516)765-1823
RECORDS MANAGEMENT OFFICER 0( �► �� Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER ' „„ ,•i"
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1266 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : LISO CONSTRUCTION CORP.
Address 1 : P. O. BOX 439
City St Zip JAMESPORT NY 11947
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.
Name Of Owner B I FU LCO, JAMES
Mailing Address 1 309 MAPLEWOOD ROAD
City St Zip HUNTINGTON STATION NY 11946
Property Address 1 NAKOMIS ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 78.00 block 3 lot 62.000
Cross Street HIAWATHA PATH
Building Permit Number Cross Reference:
Issue Date: 12/28/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
1 s ei) .... 42&/(::'
JUDITH T. TERRY ; Town Hall, 53095 Main Road
TOWN CLERK =v T i P.O. Box 1179
REGISTRAR OF VITAL STATISTICS y W �� Southold, New York 11971
�- �� Fax (516) 765-1823
MARRIAGE OFFICER Q ��
RECORDS MANAGEMENT OFFICER -x''71 $' •.' Fax
(516) 765 1801
FREEDOM OF INFORMATION OFFICER ..,iii,11#1
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: December 19, 19911
Transmitted herewith is a copy of application No. 1312 for a Cesspool/
Septic Tank Construction Permit submitted by:
Liso Construction Corp for James Bifulco •
Please review the application and location map and advise if the project
has received Suffolk County Health Department approval and if this office
may issue the permit.
Please complete the form below and return it to me.
Thank you. DEC I 91q9/
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE
Comments:
/°` I 4.
Si.nature
Dated Zj 9rZ
OFFICE OF THE TOWN CLERK
• cUr r 3(,�-;
• Town of Southold -
'.. Terry, Town Cleric • c,\.)'i- "q".<,-'7..
_ i own Hall, 53095 Main Road � i ""��=� ��" Application No�� •�—
P. O. Box 1179 ccn s:k.; F-•za..- ..
„ ;: fnConstruction z/Southold, New York 11971Off' ='�'.• � `^
�i + �� Alteration
Telephone �l �� r1b �{4 —
(516) 765- 1301 •
Residential
Non-Residen tial
•
TOWN OF SOUTHOLD .
SOUTHOLD WASTEWATER DISPOSAL DISTRICT •
APPLICA•
TION
•
for
•
•
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
•
.
y
Permit No. .
Fee .$
•
DATE A2//// •
•
APPLICANT NAME: L ' c C 0
C a hr .7 ( • C. .2.i ft”P.
- . .
APPLICANT ADDRESS: ill' C3 4• l
/� 5 •�a�
SEPTIC V CESSPOOL • -
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
'Lt, `4.dH„4i_
•
LOCATION MAP: - Must be attached hereto before
permit may be issued.
. LOCATION OF PROPOSED CONSTRUCTION. OR ALTERATION:
OWNER OF PROPERTY: J Aa•4r= •_ '
• OWNER MAILING ADDRESS: 3G'�
• ,L4-..:(A.a u b
■ ,-i i' v SA- _ `( /4) 4
• OV/NER. PROPERTY ADDRESS: erl.,,-..•_ . .
•
•
TELEPHONE NUMBER OF CONTACT PERSON; L o1I10.y 1,, ( S.
v
TAX MAP NO. : Section V • , Block 3 •
Lot �a.7
CROSS STREET: \ itLk• t.4(i,•r P�
•
BUILDING PERMIT NUMBER CROSS REFERENCE:
• Signature of • •
RECEIVED BYApplic •nt
. • i
Town Clerk's Oftice
DATE;
•
. .. .:,,..- ..,.0
_- Se : ,• " .rArritOVAt.-.
,„,,:tit
OCT 21 1994
t
S.C. DEPT. OF
H 01iP OF INTENT c,
1}x`6g t... t: ,', " ."*n,,,' ,4: e •:,. rTHE WATER SUPPLY AND SEWAGE DISPOSAL.
SYSTEMS FOR THIS RESIDENCE WILL
/ %41R :,', ,-'‘' c,; ; CONFORM TO THE STANDARDS OF THE
SUFFOL DEPT. OF EALTH SERVICES.
e l i»w •• '' . (S I
1 4,/ Sd v�f't y '&P- '7 --'4 '6(
AT- SUFFOLK COUNTY DEPT. OF HEALTH
k :a ,LJ 1-:i 0,:, L ,- P. .r : SERVICES -- FOR APPROVAL FOR
CONSTRUCTION ON
'OAC 161994
DATE:
H. S. REF. NO.. /0 -- 01- 0:4)3
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•�>c'r •. x; - ..3 '::.' '_ � APPROVED:
SUFFOLK CO. TAX M'• P DE` GNATION:
3,(: 4 A )' " 6 ; .'' . r 7'. DIST. SECT. BLOCK PCL.
OWNERS ADDRESS:
. art 0 �':; , i'. ,r•5'4:V
SIHGLE FAMILY DWELLNG ONLY
a EXPIRES THREE YEARS FROM DATE OF APPROVAL DEED: L. e;`,'76 P. .f...'!., , 4•'.•.`••+``••
TESD HOLE STAMP
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