HomeMy WebLinkAboutBobardiere, Lucille (2) iii
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ELIZABETH A. NEVILLE �•�`l`O �y�,` Town Hall, 53095 Main Road
TOWN CLERK t p '4 P.O. Box 1179
H Southold New York 11971
REGISTRAR OF VITAL STATISTICS ; ; Fax (516) 765-6145
MARRIAGE OFFICER `
RECORDS MANAGEMENT OFFICER O 1 t'
FREEDOM OF INFORMATION OFFICER �0Telephone (516) 765 1800
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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. 2130 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : HOMEWORKS MODULAR HOMES
Address 1 : C/O SANDRA PELUSO
City St Zip RONKONKOMA NY 11779
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 #R10-99-0121
Name Of Owner BOBARDIERE, LUCILLE
Mailing Address 1 19 WILSON STREET
City St Zip MASSAPEQUA PARK NY 11762
Property Address 1 2625 STARS ROAD
City St Zip EAST MARION NY 11939
Tax Map No. section 22.00 block 4 lot 3.000
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 7/29/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
A a 1 30
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ELIZABETH A. NEVILLE I Az? t•` Town Hall, 53095 Main Road
TOWN CLERK ; p -4 P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER . * / Fax (516) 765-6145
RECORDS MANAGEMENT OFFICER `."fr,f, 0\- Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ll 1-Isl.'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: July 28, 1999
Transmitted herewith is a copy of application No. 2216 for a Cesspool/
Septic Tank Construction Permit submitted by:
Homeworks Modular Homes for Lucille Bombardiere •
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.
4L ew e2.Otele4 J
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recom dations:
APPROVE
DISAPPROVE
Comments:
ignatur
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Dated
OFFICE OF THE TOWN CLERK �,'' �FFBL/i
TOWN OF SOUTHOLD '� �l /
`,�� O COG Application No. ,2 2l �P
ELIZABETH A.NEVII.LF,TOWN CLERK Qv
P.O.BOX 1179 I Z Construction
SOUTHOLD,NEW YORK 11971 Z
: 1271 Alteration
Telephone O,j► �Q� e' $10.00 - Residential ,4--
(516) 765-1801 -- �1 ;0e $25.00 -Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
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DATE 112--d
APPLICANT NAME: 461diali-S 411.4.01--(- 1 Q,Q C � jjL CI
APPLICANT ADDRESS: S�B p1Qf.�Q I , 6 I C9 , ----
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SEPTIC t CESSPOOL (
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION )C-fia\V'
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: L4611L - c'otrdceit,
OWNER MAILING ADDRESS: 6 ioI`�plrl - 4.) McmG uQ- I(3J)(,.- l I I-2
OWNER PROPERTY ADDRESS 171,r) -Z(1) 'j ALI 0(1
TELEPHONE NUMBER OF CONTACT PERSON: c (1..r2d--&-JL5-3 5 - 51S
TAX MAP NO. : Section 07 )- Block Lot 3
CROSS STREET: . ecz-6_.
BUILDING PERMIT NUMBER CROSS REFERENCE: N
nature of Applicant
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RECEIVED BY: e5
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�G�lgrk's Office
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