HomeMy WebLinkAboutGergyes, Joseph op.00
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ELIZABETH A. NEVILLE �i•4* Oy�`Z Town Hall, 53095 Main Road
TOWN CLERK p '� P.O. Box 1179
REGISTRAR OF VITAL STATISTICS y Z Southold, New York 11971
MARRIAGE OFFICER "%? ' Fax (516) 765-6145
RECORDS MANAGEMENT OFFICER `�45*, ��� �� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER --, '- jig
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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. 2149 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JOSEPH GERGYES
Address 1 : 1575 PINE NECK ROAD
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 #R10-99-111
Name Of Owner GERGYES, JOSEPH
Mailing Address 1 1575 PINE NECK ROAD
City St Zip SOUTHOLD NY 11971
Property Address 1 1575 PINE NECK ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 70.00 block 5 lot 41 .000
Cross Street OAKLAWN AVENUE
Building Permit Number Cross Reference:
Issue Date: 10/01/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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` Town Hall, 53095 Main Road
ELIZABETH A. i,•,;,�E OF Di.1- `� y�.e�� P.O. Box 1179
TOWN�;9t I '• SOU �i3OIO i
REGISTRAR OF VITAL STATISTICS °. 4's Fax(516) 765-6145 Southold, New York 11971
MARRIAGE OFFICER �
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RECORDS MANAGEMENT OFFICER y 01)*/ Telehone (516) 765-1800
FREEDOM OF INFORMATION OFFICER -=��'� 4 ioe" P
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: September 14, 1999
Transmitted herewith is a copy of application No.2235 for a Cesspool/
Septic Tank Construction Permit submitted by:
Joseph Gergyes
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 recommendations:
APPROVE ✓''
DISAPPROVE
Comments:
Signat :
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Dated
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OFFICE OF THE TOWN CLERK 4ULic' ,—..
TOWN OFSOUfHOLD Application No. � 3
ELIZABETH A.NEVILLE,TOWN CLERK
P.O.BOX 1179 ; = y= Construction
SOUTHOLD,NEW YORK 11971 ;
•
Alteration
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Telephone
‘..000
�Q���' $10.00 - Residential
(516) 765-1801 -- .� Alig
��' $25.00 -Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE j-elaJ9 , 9
APPLICANT NAME: (9_
APPLICANT ADDRESS: f 7S- �,.�J /Ltc_L 4L
Sn-ai: & ed, iv- y / .
SEPTIC >/ CESSPOOL
DESCRIPTION OF PROPOSED CON -TRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: acts V Pazae ' A
Jtfiz�s� d
OWNER MAILING ADDRESS: /5- '7 3 - � Aces[
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OWNER PROPERTY ADDRESS: ,S'Q/1
TELEPHONE NUMBER OF CONTACT PERSON: ,S /�) 7 6 5 — 1_S OS"
TAX MAP NO. : Section / 0Block U Lot `i- /- 0
CROSS STREET: `' e .
BUILDING PERMIT NUMBER CROSS REFERENCE:
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Sig1111Le' '- plicant
RECEIVED BY: -(A) I
wn Clerk's Office
DATE: C7 / /a
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JQB No. 98-55 REV 122116913 REV raoa SEP Loc REV vmw PROP SEP MILL TAX I.D.No. 100070.05.41.0
ALL DISTANCES TO WELLS AND CESSPOOLS
ARE BY LOCATIONS FROM HOMEOWNERS, JOCKEl,
FIELD OBSERVATIONS, AND EXISTING r CREEK
SURVEYS. SINCE MOST ARE NOT VISIBLE ("soak*
THESE DIMENSIONS ARE : RTIFIED.
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/ / rra. ../ 710 .. , OLK COUNTY DEPARTMENT OF HEALTH SERVICES
�.. FORAPPROVALOFCONUCT//'
UNCLE FAMILY RESIDENCE ONLY •
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?�, / $ PRO ,
/ FOR OF „H®ROOMS I
`Q'"`"+? 0'''' ...** '4/ / 1 EXPIRES THREE YEARS FROM DATE OF APPROVAL
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w SURVEY OF: LOT 6
PLAN OF LOTS
BY MR. G. WELLS PHILLIPS
/ AT PINE NECK, TOWN OF SOUTHOLD
/ / SUFFOLK COUNTY, NEW YORK
/ / FILE MAP No. 297 11\6109
cor,
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CERTIFIED ONLY TO:
// / JOSEPH AND PAT GERGYES
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By DESTIN G.GRAF N.Y.S.LIC NO.50067
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