HomeMy WebLinkAboutJ P Modular Home ,� Town Hall, 53095 Main Road
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ELIZABETH A. NEVILLE ���_� G'y ;
TOWN CLERK C P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER 1,iL ��� Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER "'/Q, #�0 1�� Fax
(631) 765-1800
FREEDOM OF INFORMATION OFFICER 0"
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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. 2264 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JOHN PRIZEMAN
Address 1 : 131 HICKS STREET
City St Zip BROOKLYN NY 11201
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 #R10-99-0224
Name Of Owner J P MODULAR HOME
Mailing Address 1 131 HICKS STREET
City St Zip BROOKLYN NY 11201
Property Address 1 10605 SOUNDVIEW AVENUE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 54.00 block 5 lot 37.003
Cross Street DOGWOOD LANE
Building Permit Number Cross Reference:
Issue Date: 3/21/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE �� G* Town Hall, 53095 Main Road
TOWN CLERK y - ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS b+' PP, Southold, New York 11971
MARRIAGE OFFICER :. 1' � ���, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER "'/Ql � S 1� Fax
(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: March 3, 2000
Transmitted herewith is a copy of application No. 2352 for a Cesspool/
Septic Tank Construction Permit submittedthy:
John Prizeman for J P Modular Home
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.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following reco dations:
APPROVE
DISAPPROVE
Comments:
Signatu
Dated
X33 eQ
• OFFICE OF THE TOWN CLERK . cAVOLK
TOWNOFSOUTHOLD �� C�
Application No.�
ELIZABETH A.NEVILLE,TOWN CLERK
P.O.BOX 1179 Construction ✓
SOUTHOLD,NEW YORK 11971
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' Alteration
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SEPTIC DETAIL Y TY not to scale vol,ovIrl
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SITUATE: SOUTHOLD
TOWN: SOUTHOLD N
SUFFOLK GOUNTY, NY kv* 10.5 11.0
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10.3
SURVEYED 09-01-cici ,
SUFFOLK COUNTY TAX#
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1000 - 54-5- 51.3
CERTIFIED TO:
JOHN PRI ZEMAN \ --------------
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in the New York St•te nes.3•LIOn of Prol•elionel
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