HomeMy WebLinkAboutGray, James ilii---
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ELIZABETH A. NEVILLE �� y<; Town Hall, 53095 Main Road
TOWN CLERK ; y - P.O. Box 1179
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Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Fax (631) 765-6145
MARRIAGE OFFICER 1i �1
RECORDS MANAGEMENT OFFICER � "q0! �aJ Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER
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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. 2375 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : ALEXANDERA JONES
Address 1 : 11A BAYVIEW LANE
City St Zip HUNTINGTON NY 11743
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 #
Name Of Owner GRAY, JAMES & HEIDI
Mailing Address 1 1270 VILLAGE LANE
City St Zip ORIENT NY 11957
Property Address 1 SOUNDVIEW AVENUE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 59.00 block 6 lot 17.000
Cross Street KENNY'S ROAD
Building Permit Number Cross Reference:
Issue Date: 7/27/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELISABETH A. NEVILLE ,���� Gyd Town Hall, 53095 Main Road
• TOWN CLERK ` H % P.O. Box 1179
Southold, New York 11971
REGISTRAR.OF VITAL STATISTICS 1,% Fax (631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER y_'jJpl '1a�00,��, 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: July 26, 2000
Transmitted herewith is a copy of application No. 2464 for a Cesspool/
Septic Tank Construction Permit submitted by:
Alexandra Jones for James/Heidi Gray
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.
4e. ),(;_e...._
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application ocation map of the project cited above
and make the following reco ndations:
APPROVE
DISAPPROVE
Comments:
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Signature r
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Dated
FROM : FAX NO. : 6736720 Jul. 26 2000 09:42AM P2
OFFICE OF THE TOWN CLERK
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TOWN OF SOUTHOLD ` 4,- Application Nocb__46.___Y
ELIZABETH A.NEVA. E,TOWN ;1-ERK ' _ "�
Construction
I'O.BOX 11'79
SOUTHOLD,NEW YORK 11571 ?T
Alteration
Telephone �yd�'� �•' 61 D.00 - Residential
(516) 765-1801P -- 'L > � X25.00 -Non-Residential
TOWN OF SOUTHOLD
SOOT' IOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CO .ISTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE "Z z QO
APPLICANT NAME:___ �?L e)C/<EAj 1>r-ci if-14.--i
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APPLICANT ADDRESS 1/4 27 v7eLv1
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SEPTIC CESSPOOL s/
DESCRIPTION OF PRCPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Mint be attached hereto before perm t may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY:
OWNER MAILING ADDRESS: /.,2 70 Lir c- 04,..)-e
OWNER PROPERTY ADDRESS:_ . ._ Sdu ,V4
5 O c,L i'
TELEPHONE NUNBER OF CONTACT PERSON: ige..Cj(Ai(/De4 ,Jori' /-4-73-
TAX MAP NO. : Section 5Cf Block Q __Lot /7 1r7 7-4)
CROSS STREET: S' oArb vo-ba 4- ii-`e y= Jr2.2I /ZP,
BUILDING PERMIT NUMBER CROSS REFERENCE:
S nater- of App ' - t
RECEIVED BY :
To vn Clerk's Office
DATE:
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Town Of Southold
P.O Box 1179
Southold, NY 11971
* * * RECEIPT * * *
Date: 07/24/00 Receipt#: 0
Transaction(s): Subtotal
1 Septic Permit-Operation - Resid. $10.00
Total Paid: $10.00
Name: Jones,Alexandra
Bayview Lane
Huntington, New York 11743
Clerk ID: LINDAC Internal ID:15478
OFFICE OF THE TOWN CLERK �COFOUre,- -
TOWN OF SOUTHOLD O Application No. 4{O 4!(
ELIZABETH A.NEVILLE,TOWN CLERK 0�, '� $10.00 - Residntia I
P.O.BOX 1179 4../
SOUTHOLD,NEW YORK 11971 *.$ $25.00 - Non-gesidential
•
t•' :
Telephone 0 4 0
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(516) 765-1801
TOWN OF SOUTHOLD
•
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSP' L
Operation Permit No. aw (d 6 /
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' V)
Fee $ •
DATE 7 v
OWNER NAME: ALC,1rJ)y'c4 .,1)1J`o
OWNER MAILING ADDRESS: On 4/1VieCd L GN,P l`!UNT/Ner4IJ v
OWNER PROPERTY ADDRESS: SID t 11I,D v/tom /'3v ,, So U .71.,L)
OWNER TELEPHONE NUMBER: (p 3) 673 - 02z)
TAX MAP NO. : Section ID® v 3j Block 0.6 Lot I. 7
CROSS STREET: K' N I S R-D
II
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New `��Existing
Residential Non-Residential
LOCATION MAP: Must be attached hereto before permit may be issued.
(Locate building and system; give north arrow and feet
of distance, approximately, to building and closest road.)
CO44 _ itRacy
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L._ ' - 1-
—Signa ure of Ap• ica t
RECEIVED BY: .
Town lerk's Office
DATE: o� `T OC-)