HomeMy WebLinkAboutAkselrad, Evan '/Ili
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ELIZABETH A. NEVILLE � '` Town Hall, 53095 Main Road
TOWN CLERK * * t P.O. Box 1179
REGISTRAR OF VITAL STATISTICS G � �
Southold, New York 11971
MARRIAGE OFFICER �` �� 1 Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER `. lX111 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICERCOM southoldtown.northfork.net
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4358-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner EVAN AKSELRAD
Mailing Address 1 16 JAY STREET #3
Mailing Address 2
City St Zip NEW YORK NY 10013-0000
Property Address 1 1355 SHORE DRIVE
Property Address 2
City St Zip GREENPORT NY 11944-0000
Owner Telephone No. 917-689-0301
Tax Map No. section 47.00 block 2 lot 2.700
Cross Street SILVERMERE LANE
Issue Date: 9/25/07 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
ELIZABETH A.NEVILLE ;��,``1` -4 �4 Town Hall, 53095 Main Road
TOWN CLERK - t P.O. Box 1179
- REGISTRAR OF VITAL STATISTICS �y, j� Southold, New York 11971
MARRIAGE OFFICER '� �� Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER = W V-.1 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER =----41, ��•,,.'. southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
OPERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $10 or Non-Residential @ $25 Application No.535 g
Permit No.y 5g
Owner Name £V4
Owner Mailing Address ((e -I A < g-' `( 03
Owner Property Address I3S'( 'F(O Q, .ep,u v
P0(br4 u`( t(q44
Owner Telephone No. 17- 6e./ • O3o I
Tax Map No: Section '14-1 Block Lot Z 7' 0 00
Cross Street S (Wet-Mei/4' 144 • '/
Please check each that applies: New Construction V
Alteration to Existing System
Residential Non-Residential
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. (Locate
building and system; give north arrow and approximate distance in feet from system to building
and closest road. New construction may submit copy of survey with SCUD approval.)
Cif":41"/64j
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Signature of Applicant Date
Received cip5iD7
$ t LATHAM
0 SAND & GRAVEL, INC.
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P.O.Box 608•Peconic,NY 11958
Office(631)734-6800•FAX(631)734-2318
October 18,2006
Suffolk County Dept. of Health Services
Office of Wastewater Management
360 Yaphank Ave., Suite 2C
Yaphank,NY 11980
Re: S.C.H.S.#R10-04-51 (Anavi/Akselrad)
Dear Sirs:
On October 10,2006 we installed a three-pool septic system for Yasmine Anavi
&Evan Akselrad, at a house undergoing reconstruction at 1355 Shore Drive,
Greenport.
• This three-pool system consists of a sealed 1000 gallon septic tank,with
Suffolk County approved#1000 cast iron grate,three 8' diameter by 4' deep cesspools,
with three 6"slab covers;leaching pools connected by crossover pipe.
The system was installed as per Suffolk County specifications,and backfilled
with clean sand. Triangulation measurements and diagram are shown on the back of
this letter.
Very truly yours,
C. —�«..t�
. Terry Latham,President
John D. Hocker,V.P., P.E.
Suffolk County License#LW-180
CTL/JDH:mgl
•
Latham Sand & Gravel, Inc.
for Yasmine Anavi & Evan Akselrad
Shore Drive, Greenport - S.C.H.S. #R10-04-0051
•
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