HomeMy WebLinkAboutReisenberg, Lloyd t t 1�,���SVjF FOL f-c
ELIZABETH A. NEVILLE ��O .y�; Town Hall, 53095 Main Road
TOWN CLERK % P.O. Box 1179
C" Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER `O Fax (516) 765-6145
Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER L O 1 P
FREEDOM OF INFORMATION OFFICER . ,��.�11 Tele
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2089 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : HEDWIG ZERVOS
Address 1 : PO BOX 382
City St Zip ORIENT NY 11957
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 #R10-99-0084
Name Of Owner REISENBERG, LLOYD & EDIE
Mailing Address 1 65 BLANCHARD ROAD
City St Zip EASTON CT 6492
Property Address 1 EAGLE NEST COURT
City St Zip LAUREL NY 11948
Tax Map No. section 127.00 block 9 lot 11 .000
Cross Street WHITE EAGLE DRIVE
Building Permit Number Cross Reference:
Issue Date: 6/18/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE )5,, 0 l/y` Town Hall, 53095 Main Road
TOWN CLERK c 1 � P.O. Box 1179
t N 2 Southold,New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER % Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER =�►.. ON- Telephone(516) 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: June 2, 1999
a087
Transmitted herewith is a copy of application No. 2177 for a Cesspool/
Septic Tank Construction Permit submitted by:
Hedwig Zervos for Lloyd £ Edie Reisenberg _ •
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 ndations:
APPROVE
DISAPPROVE
Comments:
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Dated
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OFFICE OF THE TOWN CLERK , ' �FF Wire;
TOWN OF SOUTHOLD ,s'”•
� �QG Application No. 2177
FT J7ABETH A.NEVILLE,TOWN CLERK
P.O.BOX 1179 !4.1 Construction
SOUTHOLD,NEW YORK 11971riN
Alteration
Telephone ,j' Q ,i $10.00 - Residential
(516) 765-1801 O1 �,�" $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION REir,EA1/er.
for JUN 1 1999
CONSTRUCTION or ALTERATION PERMIT
lown Cleric Soutnoid
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE (11 I c
APPLICANT NAME: w S S - "�o� "r
APPLICANT ADDRESS: p o •
012.1E tJY Ins .
SEPTIC J CESSPOOL ll
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
a 0 V\SNiV Qi CI V\ Q vve
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: L\oc v- Ec Ke_1SP,-v\e-Vl
OWNER MAILING ADDRESS: CI, S 61 ,
Qccn o-
OWNER PROPERTY ADDRESS: 1 �(Geic oe,c l JJ
0.c e e-3� Cca u r
to_u rt J ,y.
TELEPHONE NUMBER OF CONTACT PERSON: x.03 S79- - 55 51C" 911
TAX MAP NO. : Section 12:- Block (cl Lot
CROSS STREET: 0,)\117\e_ g.agl e_ _D r ��
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signaire of Applicant
RECEIVED BY:
S
Tow Cler 's Office
DATE: / / L
J
SUFFOLK SURVEY OF PROPERTY j
"� ,, 1999 APR 19 AM I I=00 A T LAUREL
\ MICE Y1ksTE HEALTH
SERVICES
TOWN OF SOUTHOLD
SUFFOLK COUNTY , N. Y.
ti .''6 1000-1Z7-O9—U f
AP
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�� ��713, 1999
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OM O STR TI the S t SURFAOAROS FORS APPROVAL cr ' 1 ltf�J
AND CONSTRUCTION OF SUBSURFACE SEWAGE le
DISPOSAL SYSTEMS FOR s l (FAMILY R( CNcts % +sl'arP
and.R abide by the condition,set forth therein to
and en the permit to construct. "' y
The I«orlons of eche one cesspools
i!0S11FPOLKCCI)MIYD�w1QY�'rClOOZA�.11ilaAViC8.1
those Penton are from field observation■
end or data obtained from others. 1 Os411* PtR�'r rp� /ALOPIILI_1�lC.sl �i sA
� s �1fi[i 0M11i.Y �eY '1
Lbt numbers rifts to-Golden Vier Estates' e� Y .L ; p9.0014
Ned In 1M Suffolk County Clerk's Office on ! _, a I, l
August 30. MN as File No. 7770. tout S1A l c / / /
Elevations ore reMeneed to on oesumed datum -t-�Yi►a �'. sa� APPROVED, f
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��� . <`� "\1 P.O. 15oTt 381
d."..\ - ,..,AREA .• 40.81118 eq. ft. 01¢t�N'r) ►vg S l
V'' % . LIC. NO. 49618
ANY ALTERATION OR A�7iON TO THIS 'AYE.'IS A W( .A11ON teas' ' Jr„
of C TON 7200 or WEND, PORK SAM WUCA 1P(4 Mw. .S C. 1h� �y7. P.C. '
PT AT PER sfL+7 7 -5 azit ALL (IIRTIFICA7►ONS (516) 765 . •
AAE VAUUD i .111$MAP.rvleb f o+Iev P. 0. BOX 909
ENO M� COPIES OEM- ASE' ' � ` , ••% 1230 TRAVELER STREET 199- 1chi,Tun,n hi V 1107/