HomeMy WebLinkAboutFeeley, Michelle (2) ,,ti0 s o�gtFFO��-c.4. -',,.O ;
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ELIZABETH A.NEVILLE ,i # Town Hall, 53095 Main Road
•
TOWN CLERK ,i o - % P.O. Box 1179
REGISTRAR,OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER `� 1,i/� s!.0 Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER '�-1 �a�0° Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER _ �os�
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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. 2315 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : MICHELLE FEELEY
Address 1 : PO BOX 1917
City St Zip SOUTHOLD NY 11971
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 #R10-00-0086
Name Of Owner FEELEY, MICHELLE & RICHARD
Mailing Address 1 PO BOX 1917
City St Zip SOUTHOLD NY 11971
Property Address 1 3430 BOISSEAU AVENUE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 55.00 block 3 lot 9.000
Cross Street YENNECOTT DRIVE
Building Permit Number Cross Reference:
Issue Date: 5/08/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
ip A•
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ELIZABETH A. NEVIL `E 4 2onn 'jd Town Hall, 53095 Main Road
TOWN CLERK y • P.O. Box 1179
�y, Southold, New York 11971
REGISTRAR OF VITAL STATISTICS `py �*. Fax(631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER � �Ql a�01� 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: May 4, 2000
Transmitted herewith is a copy of application No. 2403 for a Cesspool/
Septic Tank Construction Permit submitted by:
Michelle & Richard Feeley •
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 r commendations:
APPROVE
DISAPPROVE
Comments:
'gnature
<12 (6 6
Dated
OFFICE OF THE TOWN CLERK s�����•••••,••.,
TOWN OF SOUTHOLD ,`'1_ ��FF°tkco� Application No3 (703
ELIZABETH A.NEVILLE,TOWN CLERK ; O -
P.O.BOX 1179 ; Construction
SOUTHOLD,NEW YORK 11971v m
4 Alteration
- Residential
Telephone 1. �� $10.00 ✓ _
(516) 765-1801 �l � ,�' $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 5~4-60
•
APPLICANT NAME: 1 i LLE FSE LE_/
APPLICANT ADDRESS: R9 evx. (911 ).-0156,
Goo-al-NA I igri
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
itmc -�u.? bcAlgwkib WI 2 0/442 a ' 17 "6E
GE
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION :
OWNER OF PROPERTY: HA-LitE 004-A-a MAILING ADDRESS:`'a x I q17 k [Lg7f
OWNER PROPERTY ADDRESS: -3t) Et) ssEA“
ovr t1\ /41 ( 7(
TELEPHONE NUMBER OF CONTACT PERSON: (,2?7J 7f,,5 -flogg
TAX MAP NO. : Section55 Block _S Lot 9
CROSS STREET:J ' /JW— ��Q✓
BUILDING PERMIT NUMBER CROSS REFERENCE:
--)111Signature Applicant
RECEIVED BY: RECEIVED
MApwn Clerk's Office
DATE: T ^`
Southold Town Cleric
�/ SUFFOLK COUNTY DEPARTMENT OF BEAM SERVICES
PERMIT FOR APPROVAL OF CONSTAUCITON FOR A
TEsr G�' SINGLE FAMILY RESIDENCE ONLY
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