HomeMy WebLinkAboutSievernich �/t/ g���I
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�i Town Hall, 53095 Main Road
�` P.O. Box 1179
,0104Southold, New York 11971,sem, .I.
JUDITH T.TERRY � ioo TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 426 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : DI RICO, VAL
Address 1 : 3 JEFFERSON COURT
City St Zip SETAUKET NY 11733
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED.
Name Of Owner SI EVERN I CH, ELEANOR
Mailing Address 1 25 CINDERELLA LANE
City St Zip EAST SETAUKET NY 11733
Property Address 1 3200 COX'S NECK ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 113.00 block 8 lot 5.000
Cross Street BERGEN AVENUE
Building Permit Number Cross Reference:
Issue Date: 11/17/88 Judith T. Terry
Southold Town Clerk
(TOWN SFAI 1
9N.
OFFICE OF THE TOWN CLERK (\c.0 FOC,��,
Town of Southold �� ;.q 0
Application No. 6(39
Judith T. Terry, Town Clerk * �1 0. -4
Town Hall, 53095 Main Road o �
�, �i� � t`n � Construction
P. 0. Box 1179 %.\-- 1-`" i,,04 '
,`® " Alteration
Southold, New York 11971 fi o�-� ,
Telephone [ , Residential•
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. q)L
Fee $
DATE //A P/Pf
APPLICANT NAME: Vf41 b ; R-1 c---r.)
APPLICANT ADDRESS: 3 7-bre,----4-71.-5-6/11
/1/y/ /17 33
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
1\-ec� :1
G,.rlt.e_146
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: `e9�p yo S' 1 e ue_a_ L7 L C
OWNER MAILING ADDRESS: as lt �pJL��e. Kit),
`e, odce.wlai- Yl 173 3
3
OWNER PROPERTY ADDRESS: C, ,j / /a-(
TELEPHONE NUMBER OF CONTACT PERSON: 751— (gO / 7
TAX MAP NO. : Section I l 3 Block ^8 Lot
CROSS STREET: 3-JEA- c 7r--)
BUILDING PERMIT NUMBER CROSS REFERENCE:_.
S a &ire of Applicant
RECEIVED BY: 4-ent,c.i,
RECEMDTown C erk's Office
DATE: t,a( ) a
vV o t [� 4
Town Clerk Southold
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' , r Q �' Ya � ��1 ' 9E42/NG FROM ['EEO LIBE���3E!'P•-2/2
k u i 4 IRST I I R now or formerly Eliezer A. & Miriam Bella Frumkin LLI�q PLEASE_ 1',!
T }{OLE i BEARING FROM/EEDLlBL9'P.SB4 '
t,a�lri✓S sept
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O IVANaNY I �' '
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3 �• `.. + 6.1ZxV&I- 85 ` REVISIONS - YOUNG 8t Y1
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L 4;` 1' MAR. 21,1988 400 OSTRANDER AVENUE, RIVI
�P ND • JULY 26,1988
TH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT - ALDEN W. YOUNG
AUG. 30,1988 PROFESSIONAL ENGINEER AND
$RESl� WATER MAIN.MI + *SOURCE OF WATER:PRIVATE—PUBLIC= SEPT.21 ,1988 LAND SURVEYOR, N.Y.S. LIC. NO, 12845
=F.•CO TAX MAP DIST.1999.SECTION Its BLOCK�4_LOT_Q06 17" r
.RE ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY • SURVEY FOR:
'R THAN THOSE SHOWN HEREON. _,.,,Ini'c• I4,: UNAUTHORIZED ALTERATION OR ADDITION TO �.n n ^- .....
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