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HomeMy WebLinkAboutBerman, Alvin /o1Og-FFO----coG, ELIZABETH A. NEVILLE ��_ d • Town Hall, 53095 Main Road TOWN CLERKCA ft o ; P.O. Box 1179 REGISTRAR OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER . iiit, v �, Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER = "'/Ql �a� � Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER ��� �►� OFFICE OF THE TOWN CLERK SOUTHOLD iMKIZEMAgtlEitTEKSIPIDSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 4098-R Residential X Non-Residential Fee $ 10.00 New X Existing Name Of Owner BERMAN, ALV I N & ELLEN Mailing Address 1 50 SUTTON PLACE SOUTH, 18C Mailing Address 2 City St Zip NEW YORK NY 10022-0000 Property Address 1 215 HILL CREST DRIVE NORTH Property Address 2 City St Zip ORIENT NY 11957-0000 Owner Telephone No. 000-000-0000 Tax Map No. section block lot Cross Street 4(Y _ Issue Date: 8/08/01 'lizabeth A. Neville Southold Town Clerk (TOWN SEAL) OFFICE OF THE TOWN CLERK �FFU C /1() 7 TOWN OFSOUTHOLD � OG Applicatio ' No. LLIZABETH A.NEVILLE,TOWN CLERK • $10.00 - Residential P.O.BOX 1179 a SOUTHOLD,NEWYORK 11971 '�� $25.00 - Non-Residential Telephone *j 4 0/1 (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ /© — DATE SA/0/ OWNER NAME: 'inti,-,(_, T✓ /t./ i OWNER MAILING ADDRESS: 3'6' o?ui a, �2it e , 8c- OWNER PROPERTY ADDRESS: ` ),eu, Yo�>K /rt./ iooaa • OWNER TELEPHONE NUMBER: TAX MAP NO. : Section Block . Lot (f• 6 /g CROSS STREET: TYPE OF SYSTEM: Sept,c:: Tank / New / Existing Ces . ..00l New v Existing Regia ..iential t% Non-Residential LOCATION MAP: Must b, attached hereto before permit may be issued. (Locate: building and system; give north arrow and feet of dic:rance, approximately, to building and closest road.) Si. ature of Applicant RECEIVED BY: Town Clerk's Office DATE: • SUf �oG ELIZABETH A.NEVELLE ;'�0 Town Hall, 53095 Main Road d: TOWN CLERK k o ; P.O.Box 1179 h = ` Southold, New York 11971 REGISTRAR OF VITAL STATISTICS 1 Fax(631) 765-6145 MARRIAGE OFFICER # RECORDS MANAGEMENT OFFICER ' ��! �a1.1 � Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER _ ,,r�' OFFICE OF THE TOWN CLERK SOUTHOLD VASIREMATIBRTHISIEEDSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 2614 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : FAIRWEATHER BROWN Address 1 : PO BOX 521 City St Zip CREENPORT NY 11944 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 #R10-00-0081 Name Of Owner BERMAN, ALV I N & ELLEN Mailing Address 1 50 SUTTON PLACE SOUTH, .18C City St Zip NEW YORK NY 10022 Property Address 1 215 HILL CREST DRIVE NORTH City St Zip ORIENT NY 11957 Tax Map No. section 13.00 block 2 lot 8.016 Cross Street Building Permit Number Cross Reference: Issue Date: 7/24/01 E izabeth A. Neville Southold Town Clerk (TOWN SEAL)