HomeMy WebLinkAboutOrlin, Avigdor 0,�� SFFO7,(Cp
ELIZABETH A.NEVILLE t°�� °yam, Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �y Southold, New York 11971
MARRIAGE OFFICER : O �� Fax(516) 765-6145
RECORDS MANAGEMENT OFFICERy�f0
#901, Telephone Telephone (516) 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. 2148 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : CATHERINE MESIANO
Address 1 : 12 MILL POND LANE
City St Zip EAST MORICHES NY 11940
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 #R10-99-0175
Name Of Owner ORLIN, AVIGDOR
Mailing Address 1 C/O MESIANO
12 MILL POND LANE
City St Zip EAST MORICHES NY 11940
Property Address 1 1470 PLATT ROAD
City St Zip ORIENT NY 11957
Tax Map No. section 27.00 block 1 lot 10.003
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 9/09/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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�,o\'�. FO(�CpG-
ELIZABETH A. NEVILLE ��h'Z` � `� Town Hall, 53095 Main Road
TOWN CLERK 4 o 'g P.O. Box 1179
C13 4 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS V4' � Fax(516) 765-6145
MARRIAGE OFFICER 1�/
RECORDS MANAGEMENT OFFICER a� � Telephone (516) 765-1800
�y
FREEDOM OF INFORMATION OFFICER =�f�'�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: September 8, 1999
Transmitted herewith is a copy of application No. 2234 for a Cesspool/
Septic Tank Construction Permit submitted by:
C. Mesaino for Avigdor Orlin
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 endations:
APPROVE
DISAPPROVE
Comments:
/
,�`5ignatur
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Dated
e.
OFFICE OF THE TOWN CLERK ,O��F01�`G
1�' C
TOWN OF SOUTHOLD J Application No.�Cc y
ELIZABETH A.NEVILLE,TOWN CLERK
P.O.BOX 1179 } Construction
SOUTHOLD,NEW YORK 11971 pIT ; Alteration
Telephone sb ��•', $10.00 - Residential [—
(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 Pi) / 9?
APPLICANT NAME: AV 1 GIDUft Q.L{A)
APPLICANT ADDRESS: CIO (` . M E 5 rA- J o
12
1\,1111 Pom,CA. E. M.otz.. 1c.+1-55, NY (.1d
SEPTIC 1 CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
3 0 6 Lo S F iL � I 2- sp o of 5
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: A V 1 C-1 DUB d e C.-1 nJ CCo nl r Vt_vdee)
OWNER MAILING ADDRESS: Ic k O
12 N\1 ( oNI? (..,,a, C. opsc. Li-c s ,, N7'
OWNER PROPERTY ADDRESS: \qi c.) P1 Pr-t-1- R a C
TELEPHONE NUMBER OF CONTACT PERSON: F5-9,5-7
TAX MAP NO. : Section Block k Lot 1 0.3
CROSS STREET: lt4o5 ' S MA-IA) tc-oo_ c�
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY:/ �
Town Cle 's Office
DATE:
•
a 1
'CAIN SURVEY OF PROPERTY
AO= ROAD SITUATED AT
.ELEVATIONS (0 11VmLCee TO WN DA 1,1,wTw /SR 43) ORIENT
L»ELEVATIONS ANE>�.., mG
1.MAYO VSEPTICto TALK CA el. FON A 1 TO♦000110041 NOME R 1.0410 GALLONS.
1 000 r LOOM.a-r VOW,r-r NEP TOWN OF SOUTHOLD
3.
P66L.L 0131/1141 NON a 1r OA. TO 4 NONDON NGL"`IS MO w N 40`"ALL AREA.
( SUFFOLK COUNTY, NEW YORK
•
•.N41EAK.1,000,,,.00 S.C. TAX No. 1000-27-01-10.3
SCALE 1"=60'
rA41r41,m u0uw,PAM CERT/FLED TO: �
r.ororz0 s(nn 1041 COMMONWEALTH LAND TITLE INSURANCE COMPANY ' JULY 20. 1999
® - AVIGDOR ORLIN
4.0The 00( 41003 NOUS
i1 0404 0R ouw100s7000 SNOOP.
nto iMON.,t MOM rxLO RIVKA ORLIN AREA = 134,203.72 eq. ft.
1 ' 3.081 a.
1 TEST HOLE DATA
1 (TEST.OLE DUG BY NcOONi40 GFONJFIY F ON JULY 9, 1999)
.L ,1 y.51, a,4a ue.u
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