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ELIZABETH A. NEVILLE 4��� A Town Hall, 53095 Main Road
TOWN CLERK % co P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Q '$ Southold, New York 11971
MARRIAGE OFFICER �� y �1 Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER _ �( .�����i� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER �''•1
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2452 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : NEIL TISHE
Address 1 : 70 GROVE LAND PARK
City St Zip SOUND BEACH NY 11789
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 # R10-00-199
Name Of Owner TISHE, NEIL
Mailing Address 1 70 GROVE LAND PARK
City St Zip SOUND BEACH NY 11789
Property Address 1 205 ALDRICH LANE
City St Zip LAUREL NY 11948
Tax Map No. section 125.00 block 200 lot 1 .023
Cross Street FRANKLINVILLE ROAD
Building Permit Number Cross Reference:
Issue Date: 11/20/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE ;
�1= : ; Town Hall, 530 5 Main Road
TOWN CLERK ` y_ c€ 4 % ' P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS Pry'��' Southold, New York 11971
MARRIAGE OFFICER :
l OF10E OF THE TOWN CLERK Ie,��`/`�e,�....�..,�"
TOWN OF SOUTHOLD ��'. ��FFD�KC*,4--- Application No. Q
FI 17ABETH A.NEWT IF,TOWN CLERK P.O.BOX 1179 z IO Construction
SOUTHOLD,NEW YORK 11971 ,
Alteration
Telephone ,� t'''..
Q� ' $10.00 -Residential
(631) 765-1800 =-y1 � , $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
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DATE 6 Z3/1/4(3.
APPLICANT NAME: /f4 / ' / 7 ,;�/e..,
APPLICANT ADDRESS: 70 rot} . �C/ /?r7
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SEPTIC / CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION if/eiJ )/D/n
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTIO OR ALTERATION: .
OWNER OF PROPERTY: ,r)41 / Ale(I l et
OWNER MAILING ADDRESS:
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OWNER PROPERTY ADDRESS: 7.—i-- .`_— 's. =ter h Ric1' Ii
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TELEPHONE NUMBER OF CONTACT PERSON: / 4/02 -)/ ,
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TAX MAP NO. : Section A2.5. Block a,, Lot /. .73
CROSS STREET: /c,' ,' 1/Vil. `/€ _
BUILDING PERMIT NUMBER CROSS REFERENCE:
2
Signature of Applicant
RECEIVED BY: W A.---'L,-L,.>ce
l Town Clerk's •
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DATE: �7-d37 Q
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c�`e�\ygt �� a SUFFOLK COUNTY, NEW YORK �.
o� o� {Npv9 ugh �a S.C. TAX No. 1000-125-02-1.23
• )hy Np SCALE i iD
-(V,nc P- .. i �' Co 4 AUGUST 8„ 2000
Np "' dd' 3 o• �plaleor woo R1eAs PLor PUN
I S C0� " AREA = 130,678.16 sq. ft. //
^vit~,�i c� o 1-. 3.000 so. r CGt6't :16.
69•AA2 ��zsti ��?� '- An11�� N qk GN` 0( �v:^�/1/� �?iz�,� .
r-*1 .. .c CERTIFIED T0; y
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ls. r;��;�~ ‹t....,•-'£ ''.... .,r1.)
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�7 -( 0 NEIL TIGHE {
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2. NOW TO R8 IMP FOR 1Eli� MTA.
�y •C3 10 f 1t O' �A p� 24 % 3. MINIUM SEPTIC TMW CAPIN:NIS OR A I TO 4 P0050011 NOUSE a 1.000 GALLONS.
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s THE LOCATION OF rrELLs Me CESSPOOLS SHOWN HEREON AIM FROM FIELD
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(TEST HOLE 0uc BY ON JULY 18. 2000)
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FOR SUCH U3K-WC VIE -if SLOJE 1.4116 rd.
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Op 4: !� N.Y.S. Uc. No. 49668 �0,Os + oe V1
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70 11011 OF RT�i STATE *. .LID S 61.R
Joseph A. Ingegno �WS INN p�
,64%-•r• yv
Land Surveyor EmmaTo.E A DE NM�.,. OfNo lg $6l �\
OILYIS wv a WON PON.wsC19011,11:00110 WM= �TI MIN M 0 Nit g F e Np '''
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PHONE (631)727-2060 Fax (631)727-1727 TIIIIOIL�Mt NOT 11Yra/6Yrlir:. 9)kf. O
INE COM=OF OF OP cgs Loom AT MEM AGGRESS /OR 1nw ��h��
1300 GnNDIM M ENNE P.O. Bate 1931 ANY NOT SNOW ARF NOT '00ARA1570'ED.
MEW*Ns"York 11901 R1wMad. Now Yak 11901-0006
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