HomeMy WebLinkAboutFarahzad, Parviz - -1
Town Hall, 53095 Main Road
�O �� P.O. Box 1179
4j .�� ..�� Southold, New York 11971
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JUDITH T.TERRY /,,i���rTELEPHONE
TOWN CLERK (516) 765-1801
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. 8 N Residential Non-Residential X
Fee $ 25.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : FARAHZAD, PARVIZ
Address 1: LITTLE ROCK CONSTRUCTION INC.
P.O. BOX 209
City St Zip STONYBROOK NY 11790-0000
Descripton of Proposed Construction or Alteration
NEW RETAIL/OFFICE COMPLEX WITH CESSPOOL SYSTEM
APPROVED AS PER SUFFOLK COUNTY HEALTH DEPARTMENT APPROVAL
Name Of Owner FARAHZAD, PARVIZ
Mailing Address 1 P.O. BOX 209
City St Zip STONYBROOK NY 11790-0000
Property Address 1
MAIN ROAD
City St Zip MATTITUCK NY 11952-0000
Tax Map No. section 122. 00 block 6 lot 31. 000
Cross Street FACTORY AVENUE
Building Permit Number Cross Reference:
Issue Date: 4/28/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
C
!PR 2 f roo y3 I ,, .
BLDG.DEF . j�'. Town Hall, 53095 Main Road
4
:13 , .NN> P.O. BOX 728
Southold, New York 11971
JUDITI I T.TERRY TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
•
April 26, 1988
To: Victor Lessard, Southold Town Building Department
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy of application No. NR 8 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by Parviz Farahzad (Little Rock Construction, Inc.) .
Please review the application and location map and advise if the
project has received Suffolk County Health Department approval
and if we may issue the permit.
Please complete the form below and return it to my office.
Thank you.
eir •
es°41
Judith T. Terry
Southold Town Clerk
I have reviewed the application and location map of the project
cited above and make the following recommendation:
APPROVE - X
DISAPPROVE -
COMMENTS: t _. ., _ : _ _ ! .►. '
\(:±51.0 (fiZMAI
Signature
Date
'OFFICE OF THE TOWN CLERK
--
Town of Southold Application No.NR
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road 9 Construction
P. O. Box 1179 0` • Alteration
Southold, New York 11971 .yL ��-
Telephone ��l i [ �� Residential
(516) 765-1801 ' Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ J_ D
�Q8rYtL Fu-reoftMT �ZCQ ���$
L+iWe pock QoNswrrc44f aN,
APPLICANT NAME: c2�4ttI42- F Za1.AD ?Li/
APPLICANT ADDRESS: ?m.
51.mtbassie, . l t7go
SEPTIC CESSPOOL 1
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
NU-) (otic4rt ►+(-4 /01T-KE..
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:�
OWNER OF PROPERTY: l,�yt2. 6442•zl
OWNER MAILING ADDRESS: f O. euric -2S1
. ['t710
OWNER PROPERTY ADDRESS: PA0114 Fo100 Clv-1.5. ?cute 'ZS)
t*W'W f
TELEPHONE NUMBER OF CONTACT PERSON: 744-01)49
TAX MAP NO. : Section lt2. Block oce Lot 31
CROSS STREET: ? tdA.Pl
BUILDING PERMIT NUMBER CROSS REFERENCE:
•
toCI
Signature of Applticant
RECEIVED BY :
.wn '17 s I ice
DATE: c4
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APPRO- N.S.REF.N0.///I-W7-Oa O FLOW SS-OC
TYPE ,40,7-�,/w4l,.4rf2/2 ;t0 O<L.c,
This approval is granted for the construction of the sin'
disposal and water supply facilities pursuant to Articles VB
7 01 the Suffolk County Sanitary Code and a not an expre:
nor implied approval to discharge from or occupy
• structurels)shown. THIS APPROVAL EXPIRES 11V0 12
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ilt APR 21 1988
DATE� ILr DATE SIG
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