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JUDITH T.TERRY Town Hall, 53095 Main Road
TOWN CLERK g t P.O.Box 1179
O 1 Southold,New York 11971
REGISTRAR OF VITAL STATISTICS ® �1 Fax(516)765-1823
MARRIAGE OFFICER =_� °��1i
RECORDS MANAGEMENT OFFICER - ® Vo
Telephone(516)765-1800
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FREEDOM OF INFORMATION OFFICER Fax
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1312 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PATRICK FEDUN
Address 1: 159 TROUT BROOK LANE
City St Zip RIVERHEAD NY 11901
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. #R10-95-0033
Name Of Owner RUFRANO, CARMINE
Mailing Address 1 MAIN ROAD
City St Zip LAUREL NY 11948
Property Address 1 EAGLE NEST COURT
City St Zip LAUREL NY 11948
Tax Map No. section 127.00 block 9 lot 4.000
Cross Street WHITE EAGLE DRIVE
Building Permit Number Cross Reference:
Issue Date: 4/07/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY %' - t. Town Hall, 53095 Main Road
TOWN CLERK : ® I P.O. Box 1179
un Southold, New York 11971
REGISTRAR OF VITAL STATISTICS - Fax t% Fax (516) 765-1823
MARRIAGE OFFICER _r,� ®I�} Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER = ®1 ��
FREEDOM OF INFORMATION OFFICER -".�:rir1rr°�'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD , D , « __
TO: Southold Town Building Department
It
FROM: Linda J. Cooper, Southold Town Clerk's Office BLDG DEF-
; TOWN OF SOUTHOLD
DATED: April 3, 1995
Transmitted herewith is a copy of application No. 1361 for a Cesspool/
Septic Tank Construction Permit submitted by:
Patrick Fedun for property owned by Rufrano _ •
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: 1,�� 4c1 . o - ,d - -o1&&3
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Signatu,e
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Dated
OFFICE OF THE TOWN CLERK , ,'"
Town of Southold ,.1'" Voute
r'J _ �� Application No. 13 `e
Judith T. Terry, Town Clerk '�' �.' y_ l/y
Town Hall, 53095 Main Road L ; Construction 11
P. O. Box 1179 a :2. ' ,zT,
Southold, New York 11971 : cn :. ; .; �• Alteration
Telephone
$10.00 - Residential l/
(516) 765-1801 = 1 1 ,, $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
APPLICANT NAME: 70.4g (C-
APPLICANT ADDRESS: S I - mil c C( Ca
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: . Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERA ION: P r•c(r� 0�,,� Sa�`•
OWNER OF PROPERTY: Ccti2/1,it (.r a'-t & ye.f . r j -t+ 6. Pe. to JO
OWNER MAILING ADDRESS: f11ai Ad
/ auRe I1 (L1Y.
OWNER PROPERTY ADDRESS: gsle Le,S7 C
�Gu ao ff.
TELEPHONE NUMBER OF CONTACT PERSON: 676 - 7c - 3 3
TAX MAP NO. : Section ✓ '7 Block Lot *
CROSS STREET: LAI e4,31(0
BUILDING PERMIT NUMBER CROSS REFERENCE:
- l.< 76 �.
R E C E 6 V E (
Signature of Applicant
RECEIVED B)jpf?
T0�05 Clerk's Office
DATE: Southold Town_Cierk •
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UNATHORRED ALTERATION OR ADDITION
.: TO THIS SURVEY IS A VIOLATION OF
1 ' SECTION 7209 OF THE NEW YORK STATE
fI' EDUCATION LAW '
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CORES OF THIS SURVEY MAP NOT BEARING C)j
THE LAND SURVEYOR'S INKED SEAL OR
EMBOSSED SEAL SFW1_NOT BE CONSIDERED I TO BE A VALID TRUE COPY. S
GUARANTEES INDICATED HEREON SHALL RUN cP.
ONLY TO THE PERSON FOR WHOM THE SURVEY e
1 IS PREPARED.AND ON HIS BEHALF TO THE }
I TIRE COMPANY. GOVERNMENTAL AGENCY AND
LENDING INSTITUTION LISTED HEREON,AND J
I - TO THE ASSIGNEES OF THE LENDING INSR-
I': TUTION.GUARANTEES ARE NOT TRANSFERABLE
1:
THE EXISTANCE OF RIGHT OF WAYS
,, AND/OR EASEMENTS OF RECORD, IF I
I ANY, NOT SHOWN ARE NOT GUARANTEED. /
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PREPARED IN ACCORDANCE WITH THE MINIMUM
i, Joseph A. In e n® STANDARDS FOR TITLE SURVEYS AS ESTABLISHED
o k1 �j G BY THE LI.A L.S AND APPROVED AND ADOPTED
SUCW USE BY THE NEW YORK STATE LAND
I
. Land Surveyor P��aF wF�.��IA/KIN
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J` ?0' Fox (516)722-5093 � fi. 1�
MAILING ADDRESS 4,-"%� =e!
P O. Box 19315 s AMD
931 Riverhead, New York 11901 _ N.Y.S. Lic. No. 49668 1
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