HomeMy WebLinkAboutCaselnova, Ralph \WV
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ELIZABETH A.NEVILLE .ZO Gy�� Town Hall, 53095 Main Road
TOWN CLERK -� x P.O. Box 1179
kt5:3 Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS 49 Fax (516) 765-1823
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER y, Telephone (516) 765-1800
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FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2216 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : SPITALIERE CONSTRUCTION
Address 1 : PO BOX 552
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 #R10-99-171
Name Of Owner CASELNOVA, RALPH
Mailing Address 1 3355 COLONY DRIVE
City St Zip BALDWIN NY 11510
Property Address 1 26609 MAIN ROAD
City St Zip ORIENT NY 11957
Tax Map No. section 18.00 block 3 lot 9.008
Cross Street ROUTE 25
Building Permit Number Cross Reference:
Issue Date: 12/28/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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` ELIZABETH A.NEVILLETown Hall, 53095 Main Road
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TOWN CLERK , o P.O. Box 1179
REGISTRAR OF VITAL STATISTICS t; Southold, New York 11971
MARRIAGE OFFICER *V 0 Fax(516) 765-6145
RECORDS MANAGEMENT OFFICER ��y�f0 a0�'1�� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER - '� �
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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 : December 17, 1999
Transmitted herewith is a copy of application No. 2304 for a Cesspool/
Septic Tank Construction Permit submitted by:
Spitaliere for Ralph Caselvova
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:
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Dated
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OFFICE OF THE TOWN CLERK ,' i'
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TOWN OFSOUTHOLD `' Q Application No. 3c,
ELIZABETH A.NEVILLE,TOWN CLERK
Construction
P.O.BOX 1179 `
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SOUTHOLD,NEW YORK 11971 ipm
Alteration
/ - Residential$10.00 -
Ridial /�
Telephone '‘20
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(516) 765-1801 I
'' $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 /2/i7 i 'I`1
APPLICANT NAME: _2'/7�.(4 x. ,1 1, (e<��, )
APPLICANT ADDRESS: /1. Q /3PX
SEPTIC CESSPOOL '-
DESCRIPTION
DESCRIPTION OF /PROPOSED CONSTRUCTION OR ALTERATION
,be .0v- 2 1 1 " 7 y /7? , � A7-t-,J
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALT,RATION :
OWNER OF PROPERTY: /Ze%' iiv �, ��y _ A,//>i/4
OWNER MAILING ADDRESS: 33x3- <<>/ri y i2 . —/ ,.�/ //-5
OWNER PROPERTY ADDRESS: , . I a(4 as lb,
(t9(0CYC3
TELEPHONE NUMBER OF CONTACT PERSON: 7/S ll///
TAX MAP NO. : Section /,Y Block_= - Lot
CROSS STREET: ) /.e 2-r
BUILDING PERMIT NUMBER CROSS REFERENCE:
ire of Applicant
RECEIVED BY: /DL
Town Clerk's 'ce
DATE: / 4// 47/94
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