HomeMy WebLinkAboutFerraris, Mark , l __ __,,
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JUDITH T.TERRY ; o= r4 % Town Hall,53095 Main Road
TOWN CLERK t vs Z $ P.O.Box 1179
'�t Southold,New York 11971
REGISTRAR OF VITAL STATISTICS 1 Fax(516)765-1823
MARRIAGE OFFICER :LAa0 01
RECORDS MANAGEMENT OFFICER : ! Ai *JO Fax
(516)765-1800
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. 1352 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : STEVEN H I LDRETH
Address 1 : BOX 761
City St Zip REMSENBURG NY 11960
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. SCHD REF. #R10-95-0084
Name Of Owner FERRARIS, MARK AND NANCY
Mailing Address 1 40-01 LITTLE NECK PKY.
APT. 18B
City St Zip LITTLE NECK NY 11363
Property Address 1 ORCHARD STREET
City St Zip ORIENT NY 11957
Tax Map No. section 27.00 block 2 lot 2.010
Cross Street HALYOAKE
Building Permit Number Cross Reference:
Issue Date: 7/12/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
\ / , S--C"
,,$141 COFotK�oo
JUDITH T. TERRY :$. • L ; Town Hall, 53095 Main Road
TOWN CLERK : =v T ; P.O. Box 1179
if * �� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = V0 ��� Fax (516) 765-1823
MARRIAGE OFFICER '_., 11° '.� Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER _ ,l41i
FREEDOM OF INFORMATION OFFICER x..,1,1,0.1���
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department A -6 IIII
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: July 6, 1995
Transmitted herewith is a copy of application No. 1110k for a Cesspool/
Septic Tank Construction Permit submitted by:
Steven Hildreth for Mr. & Mrs. Mark Ferraris .
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 j/
DISAPPROVE
Comments: 7A/' cJ -4yd' sc4 ty40- 93 -Ov
—RECIPVED-----
JUL 1 1 1995 / `,/
Town Clerk Soutldi
Signature •
7 /19fr
Date
w
OFFICE OF THE TOWN CLERK �,,,,•"""'••.,
Town of Southold �,'� \001./(0-
Application
01./( Pilot,
Judith T. Terry, Town Clerk ��`���. ' ��l/y�: Application No. P `7
F.
Town Hall, 53095 Main Road �` <: Construction
P. 0. Box 1179 •
o ,_
Southold, New York 11971 • tt� �• Alteration
Telephone -a �Q�;•' $10.00 - Residential / V
(516) 765-1801 "l * ,, ' $25.00 - Non-Residential
• �� ii „,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE 7 `1
APPLICANT NAME: ' 4
APPLICANT ADDRESS: - — — lin 1
SEPTIC X CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
til 4i-
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: M12.. . vie ac��
OWNER MAILING ADDRESS: Lf ` c ( Le- (85
OWNER PROPERTY ADDRESS: c: 'e-c- -h-‘2.-(D `=fir
t � PSI
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section <5'Z7 Block -Z.— Lot 2- , 1 C7
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY: )yyy////���JJJ
To v�i i Clerk's Office
DATE: 7l b7/.-
SUFFOLK CO.HEALTH DEPT.APPROVAL
I c\.1
v , , H.S. NO.
H SUFFOLK C1TY
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STATEMENT OF INTENT
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SYSTEMS FOR THIS IRESIDEFICE,, WILL
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CONFORM TO nee srmcmacw.ar me
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