HomeMy WebLinkAboutLewis, Helen ' CORRECTED PERMIT
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JUDITH T. TERRY ;/41 Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1 179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER y V� �„ ��� Fax (516) 765-1823
�** e Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 767 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JOHN SCARAMUCCI
Address 1 : P. O. BOX 1403
City St Zip MATTITUCK NY 11952
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 10/3/91 .
Name Of Owner LEWIS, HELEN & PENRAAT, MIRJAM
Mailing Address 1 200 EAST 74TH ST.
City St Zip NEW YORK NY 10021
Property Address 1 705 BAYVIEW AVENUE
City St Zip MATTITUCK NY 11952
Tax Map No. section 106.00 block 10 lot 1 .002
Cross Street COX NECK ROAD
Building Permit Number Cross Reference:
Issue Date: 10/17/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
JUDITH T. TERRY ;,•
.40
Town Hall, 53095 Main Road
TOWN CLERK T ; P.O. Box 1 179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ` • Fax 516) 765-1823
MARRIAGE OFFICER 00 �. •
��O ��� �• Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 767 R Residential X Non-Residential
Fee $ 10 Septic X Cesspool
PERMIT ISSUED TO:
Name : LEWIS, HELEN & PENRAAT, MIRJAM
Address 1 : 705 BAYVIEW AVENUE
City St Zip MATTITUCK, N.Y. 1195 2 11952
Descripton of Proposed Construction or Alteration
NEW CONSTRUCTION
Name Of Owner LEWIS, HELEN & PENRAAT, MIRJAM
Mailing Address 1 200 EAST 74TH ST.
City St Zip NEW YORK, N.Y. 10021
Property Address 1 705 BAYVIEW AVENUE
City St Zip MATTITUCK, N.Y. 11952
Tax Map No. section 1 .06 block 10 lot 102
Cross Street COX NECK ROAD
Building Permit Number Cross Reference:
_10444;14egepordi
Issue Date: 10/17/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
o G'y
JUDITH T. TERRY % Town Hall, 53095 Main Road
TOWN CLERK ,I v FM P.O. BOX 1 179
REGISTRAR OF VITAL STATISTICS . EP 'W Southold, New York 11971
MARRIAGE OFFICER ‘V,4.
v F.
�� Fax (516) 765-1823
��� � • �.'
— Fax
(516) 765-1801
. 1
OFFICE OF THE TOWN CLERK, L''';-?;7__11/9„.':111..."
� J ry
1 '
TOWN OF SOUTHOLD N,I'# u
�� i OCl' ` T 1991
LI UL
To: Southold Town Code Enforcement Officer /� -1p� ; .._..... �
From: Linda Cooper, Southold Town Clerk's Office 4-.i,.�'f 5
Dated: October 7, 1991
Transmitted herewith is a copy of application No. 789 for a Cesspool/
Septic Tank Construction Permit submitted by:
John Scaramucci for Helen Lewis and Mirjam Penraat .
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.
Ce444"‘ta
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE x
DISAPPROVE
Comments: q,.. ,4.4.,, $ q,,dt J.Q4 It.)›.
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(4. c.51a4,LIP.4-6Q—
Signature
Jo, 9 \ 9I
Dated
•
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OFFICE OF THE TOWN CLERK ��jvFf�J
Town of SoutholdO
Town Clerk �� ' Application No. 0 9
Judith T,, Terry, r:.. . ,,
Town Hall, 53095 Main Road ' � ,, ;: Construction ✓
P. O. Box 1 179 u�O`.. ea* .•,,; y
Southold, New York 11971 ,{ Alteration
Tele hone "°1 r e NN�6,.,0 " Residential
P
• (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 $ `b i
DATE /0/ /
APPLICANT NAME: i!:31M) --Cr 7eteC-r7
APPLICANT ADDRESS: B01/903
tV4Ni' ( /v ``T,. /(9
SEPTIC C- CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
/4
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR/i '7ij* ,
ALTERATION:
OWNER OF PROPERTY: / .(e,�) Lek)/S / qLOWNER MAILING ADDRESS: OOCO . 7714 37L.
/Ue w !v.L./C, v''7 /01061-12-
OWNER
D /LOWNER PROPERTY ADDRESS: 70S 4. . -
/1119 4uC.l<
TELEPHONE NUMBER OF CONTACT PERSON: Z9b-- 9630
TAX MAP NO. : Section /06 Block / 46 Lot f Z
CROSS STREET: Case A3eC/C
BUILDING PERMIT NUMBER CROSS REFERENCE:..
!t/Y,1'1- -t€
Signature of Applicant
RECEIVED BY:
maw Town Clerk's Office
DATE:_'
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