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HomeMy WebLinkAboutPratt, Miriam I,„ -i�.- ••0s' FFOL,j-A, 0ELIZABETH A. NEVILLE 1I ��: Town Hall, 53095 Main Road TOWN CLERK ; H Z $ P.O. Box 1179 REGISTRAR OF VITAL STATISTICS • Al �$ Southold, New York 11971 MARRIAGE OFFICER y ��0/� Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER =___-.4 *iNgDi"" Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER -- ����e�i OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 2461 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : SCHEMBRI HOMES INC Address 1 : 2042 NORTH COUNTRY ROAD City St Zip WADING RIVER NY 11792 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 # R10-00-0054 Name Of Owner PRATT, MIRIAM & WILLIAM Mailing Address 1 46 NIKIA DRIVE City St Zip ISLIP NY 11751 Property Address 1 2705 NORTH BAYVIEW ROAD City St Zip SOUTHOLD NY 11971 Tax Map No. section 79.00 block 2 lot 11 .000 Cross Street NORTH ROAD TO BAYVIEW Building Permit Number Cross Reference: Issue Date: 11/20/00 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) if I a ~ 11/1�S11FF04 . 1, ( 1 ELIZABETH A. NEVILLE �11= GZ�: Town Hall, 53095 Main Road TOWN CLERK ; y P.O. Box 1179 REGISTRAR OF VITAL STATISTICS $ Southold, New York 11971 MARRIAGE OFFICER � .fail. �4,1� Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER =__'/O! ����i� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER �•� .00sJig �0� OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: November 8, 2000 Transmitted herewith is a copy of application No. 2549 for a Cesspool/Septic Tank CONSTRUCTION/ALTERATION Permit submitted by: Schembri for Miriam& William J. Pratt 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 DISAPPROVE Comments: Maintain required setbacks from adjacent wells, buildings,property lines and water Bodies. EXCAVATION INSPECTION REQUIRED. Signature IL14 /o0 Dated d... OFFICE OF THE TOWN CLERK �����,��•••••••••���� _ ,••o5�FF0L'�toG Application No.2 ) TOWN OF SOUTHOLD 6 Fti7ABfiTH P.O.AOX E,TOWN CLERK i O 41 Construction P .BOX 1179 SOUTHOLD,NEW YORK 11971 : 0 �� . Alteration Telephone :0,� �Q�i�'` $10.00 - Residential v C , (631) 765-1800 -.1 ' $25.00 - Non-Residential ..,.oai, TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee $ DATE ///3/ov APPLICANT NAME: el7/&: e/ //u4 S -Z)0C APPLICANT ADDRESS: 004 10. 600/07-12V 4) 4-4 JAk G /e-i�L X-J ( /' 79 A- SEPTIC /CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: ij/4 /n oG&It Lc c ,gh/ T /W2-7-- OWNER ,r 1r'�OWNER MAILING ADDRESS: 44, -0//// J,Jtg,. SSG rte' , -V //7 1'/ OWNER PROPERTY ADDRES S /2774 /Uj�-24) Z' b TELEPHONE NUMBER OF CONTACT PERSON: 7.;) -96c..// TAX MAP NO. : Section /POO Block j2 75 Lot p; -- /1 CROSS STREET: ,e,16 -17- Aft/41 ,rej tqp-,4/b7e k) BUILDING PERMIT NUMBER CROSS REFERENCE/ Pr -14/ . Signat % of Applicant .._iRECEIVED BY • / T w Ck Ie 's Office DATE: // g e, f� etl .1/tis { 3. $ IT COA1FdRM 1. •, M V S"I'I! THE yF � mi,,,,,,. .- ,-.1\DP " . ,1 t�.,,tf. McCRrHv SUFFOLK CO.,DEPT. OF HEALft4 f ' • , �� , Ar ARlit`tCA/fT .��,,, '�° t� , , o BAYVIEW y �(,d4 ',; J SUFFOLK COUNtY DEPT. Of #r` ----)\ rQ N Fr O H _ :gip WO s Mit A _ RS uT DLO, nl. Y. SERVICES FOR APPRt7vA 4 .,". .1 �.5• a 31 c`f th ��J CO ISTRUC'XION ONLY11 ti, �t n g i \ ti / I H. S. REF. NC>:i2JO-95 .ak Aii - . , . i ,' �c ale` r ,4p'�r�N A Rav : ` •SUFFOL.K Co':TA MAP e: ;• A. 11.;,1"';'- a roe .- ,- �" ' Q ? 2'` t 8 DIST. SECT. SL 4. Areel , 'f S ft. t0O 1► 0 If.. K r , -A t OWNERS ADDRESS: ' 5s, r -S?li % i q • A' a 1Yl0nu arcf 044 *Crii M. ? `' ,N'lk , `� , I \ 746" 2,1100 ,, Pr +. �;i x �i �4st`icam dyc� unr c�u�' `ro�rr C'cfu rn�c` , .'. f �' oif`a: �. 13 P. t iv i..�_ ...."..j 1.... I - .. �i `w- 'TEST N .� ~AMP .�.. i l �'' ; r '0• j 1 - Unauthorized.toodka er r 4* x r /zs.• .. - � '� '. ��JP L�0�1I+f lY I�BFARTIVtFW3'dF HEALTH SBRYfa$ Section rlos a 'fait Cate 4 �; ..� I �' t Education lair• a tal err Mit APPROVAL OF /ORA brrofurr. �� copies Mills suivitY I s' 4 / Wv ! S 4/Y, embossed sesl shat net be oonsidwed In 27 set 1 the land suiveyoes Inked seal ce lt 'a I ) fra • r / / RLO—qs ods- __._ -- .• I tobeavoidtrwow I e �.�l`�-2b-Cl� A , G„N„as*Imiat�edbneonshsiroe s I _ C 60%ex, '0:71". a,q,to u,e person for whom a,.savoy tis rf 44 73. �.V. ...,•-- •- -- / fj wok;prepsrod•arganhbbehefMM Alik :11.1 1s e' Ds'Os+rf +uon N:wedtronan.nd _I to the assignees a the WO;tu0• Won.c .a .+wrrw�w. OAtiel4"kei 12eiAt7 2 71�VR1�l IAA�SOPAP VAL -• I /I'se to.datantInstitutions a , ?JZf, 6 � 1 coaPoe �6 ©i SEA.. A"i asrsd _ .... /J re,......ollp.*. x 7, 1�M• "° tfeam,:sipy vittwilita41 1 i� ,* aF - . * , 1 R ( ti- it % .,... ;��� —6 0k;