HomeMy WebLinkAboutStagias, Karen oolitfF014- "L"
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ELIZABETH A. NEVILLE � _ tk Town Hall, 53095 Main Road
TOWN CLERK ; y P.O. Box 1179
REGISTRAR OF VITAL STATISTICS $ Southold, New York 11971
MARRIAGE OFFICER �� y 0.10
Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER � 'Ol #01. Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ����'��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2418 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : LISO CONSTRUCTION CORP.
Address 1 : PO BOX 439
City St Zip JAMESPORT NY 11947
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 #R10-00-0216
Name Of Owner STAGIAS, KAREN
Mailing Address 1 39-74 48TH STREET
City St Zip ASTORIA NY 0000
Property Address 1 REEVE AVENUE
City St Zip MATTITUCK NY 11952
Tax Map No. section 100.00 block 3 lot 15.009
Cross Street SEA AIRE WAY
Building Permit Number Cross Reference:
Issue Date: 10/10/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE1�1= y1 Town Hall, 53095 Main Road
TOWN CLERK , co Z P.O. Box 1179
REGISTRAR OF VITAL STATISTICS $ Southold, New York 11971
MARRIAGE OFFICER :L y ��111 Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER ._'7O, **pi" Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER �, •°°°°��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: September 28, 2000
Transmitted herewith is a copy of application No. 2506 for a Cesspool/Septic Tank Construction
Permit submitted by:
Liso Construction Corp. for Karen Sta2las
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.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE l/
DISAPPROVE
Comments:
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ynatur
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Dated
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OFFICE OF THE TOWN CLERK ��1FFo�l�l' -
TOWN OF SOUTHOLD ,',�_� QG -` Application No. 5O
ELIZABETH A.NEVI LE TOWN CLERK �7
P.O.BOX 1179 Oft. ��; Construction OZ._SOUTHOLD,NEW YORK 11971
Alteration
$10.00 - Residential
Telephone *a/ l;sDO�
(631) 765-1800 = . do' . $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE / a�
APPLICANT NAME: � S 0 L ,0. e,
APPLICANT ADDRESS: Pr-L j3 a/ 4-13Gf
J .w r-Cr P u !�T ). .� • 1 14 4-1
SEPTIC ,- CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
IL n 0 1-1- -
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: /`i
OWNER MAILING ADDRESS: 31 -7q- 11- "r,, ST�/�/,cl H.1/4-7
OWNER PROPERTY ADDRESS: 5 �. � n•�G�c`
TELEPHONE NUMBER OF CONTACT PERSON: 7,,Z.2 - 4/747
/747 L. !Sv
TAX MAP NO. : Section Block 3 Lot /✓- 9
CROSS STREET: c014--
BUILDING PERMIT NUMBER CROSS REFERENCE:
-00
•
Signature of Applicant
RECEIVED BY: ,/ / 2_
T•wn Clerk's Office
DATE: i re
lempr 4
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URVEY OF LOT 9 MAP OF SEA -A/RE ESTATES .--, ``o"
FILED : FEB. 5, /979 - FILE # 6780
SITUATED AT MATT/TUCK, TOWN OF SOUTHOLD, SUFFOLK COUNTY, N. Y. -J
GUARANTEED TO : GNA ABSTRACT CORP. ._
appFoug Ccpumy , , Y°1 ;; COMPANY
*A " vW..„7''jj' g4 4.A' ST, IAS,PEGGY STAG/AS
Sums PAW Rlt,Otacs.ON#.Y SORVEYED : JAN. G, 2000
Ar''' PWT PZAN : AuG. 30, Ze:20C.7
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�,�uuaau"or k"'2 �-.` '� '"' 'HARRY P. HILLI�BR,4ND—
�MR�R YwR�FROM� ' 4 LAND SURVEYOR
FFOLK COUNTY TAX MAP _ it CHURCHILL LANE - SMITHTOWN, N.Y.
DISTRICT S CTION BLOCK LOT TEL. 543-5139
1000 . 00 3 /5.9
NASSAU SUFFOLK BLUEPRINTING File 99292