HomeMy WebLinkAboutFrederick, Edward 41.Of al
JUDITH T. TERRY ` iG Town Hall, 53095 Main Road
TOWN CLERK 0 ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER ;%'Q'�O
jig ��0T,,•�� Telephone l6)(516)57651801
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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. 662 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : EDWARD L. FREEMAN
Address 1 : P. 0. BOX 523
City St Zip AQUEBOGUE NY 11931
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 11/8/90.
Name Of Owner FREEMAN, EDW (CONTRACT VENDEE)
Mailing Address 1 BARBATO - OWNERS
20 WILLETS PL
City St Zip HUNTINGTON STATION NY 11746
Property Address 1 CLEARVIEW AVENUE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 70.00 block 8 lot 39.000
Cross Street WILLOW LANE
Building Permit Number Cross Reference:
Issue Date: 11/20/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY : Town Hall, 53095 Main Road
TOWN CLERK 1=9
T P.O. Box 1179
REGISTRAR OF VITAL STATISTICS 1.01 • Southold, New York 11971
MARRIAGE OFFICER :%0 �� Fax (516) 765-1823
., ' ������� Telephone (516) 765-1801
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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. 662 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : EDWARD L. FREEMAN
Address 1 : P. 0. BOX 523
City St Zip AQUEBOGUE NY 11931
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 11/8/90.
Name Of Owner BARBATO, SALAVATORE & VINCENT
Mailing Address 1 20 WILLETS PLACE
City St Zip HUNTINGTON STATION NY 11746
Property Address 1 CLEARVIEW AVENUE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 70.00 block 8 lot 39.000
Cross Street WILLOW LANE
Building Permit Number Cross Reference:
Issue Date: 11/20/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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of
N7 tfeA%?
4 _ $ Town Hall, 53095 Main Road
0 °.:' �. •�` P.O. Box 1179
O :� ������ Southold, New York 11971
JUDITH T.TERRY � TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Southold Town Code Enforcement Officer ( ' 4
From: Linda Cooper, Southold Town Clerk's Office {
Dated: November 14, 1990 TOWN OF SOUTHOLD j
Transmitted herewith is a copy of application No. 678 for a Cesspool/
Septic Tank Construction Permit submitted by:
Edward Freeman
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 1 . .1 Ito / ..
C3t.X.4›-ixii.1 *cdatc)• \
trNeN
\CAU-k( IcukAP..
Signature
11'IL �O
Dated 111
` ,,•
OFFICE OF THE TOWN CLERK C�FFULA/`,"
�.,..
Town of Southold Offs y
Town Clerk _: l Application No. 7
Judith T. Terry, ,;. ,,�
Town Hall, 53095 Main Road n# ter>< ;r;a. '� Construction
P. O. Box 1179 �.
Southold, New York 11971 Alteration
Telephone
15:1 ��� Residential �-
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
/1)1
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$ ip —
DATE 7(4.7/7
APPLICANT NAME: 4.00.-rp1 ,7i- /;€'e x (e.,0A) 77,9G-14-_)
APPLICANT ADDRESS: /jjt-e Sr ‘ffv P,64,7v e
,9r l3or
5:25
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: SA�igvAT�e�
OWNER OF PROPERTY: 2i),e RA-7-0) t//vC�v ?--
OWNER MAILING ADDRESS: .20 t,.)< f/.eats 10/.
OWNER PROPERTY ADDRESS: CL,erl 2 U% e
So co-A..A-«
TELEPHONE NUMBER OF CONTACT PERSON: g — /j/'77
TAX MAP NO. : Section D 7d Block 8 Lot 3�
CROSS STREET: (//'//ate
BUILDING PERMIT NUMBER CROSS REFERENCE:..
Signature of Applicant
RECEIVED BY: ierle7sVfte—
DATE:
Town/l /l /4/11,9
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SUFFOLK CO. HEALTH DEPT. APPROVAL
H.S. NO.
_ -
I
MAP OF -PROPEf2TY . .,
. ..
...
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SLLIZVEYED For? . • ,
'1\11 PD L. F-2EEVAN
, STATEMENT OF INTENT •
THE WATER SUPPLY AND SEWAGE DISPOSAL
'
v . it
. SYSTEMS FOR THIS RESIDENCE WILL
50j1-1-101.-C . CONFORM TO THE STANDARDS OF THE
ItiWN OF
SUFFOLK CO. DEPT. OF HEALTH SERVICES..51;L 'OLI: NY, ' (S)
APPLICANT .
_f:i SiTi;CES
7l ir • SUFFOLK COUNTY DEPT. OF HEALTH
•
SERVICES - FOR APPROVAL POR
. 1,..-, •
' CONSTRUCTION ONLY -• • i• ;
Oitorp,.. /=!..? * V . DATE:
. H. S. REF. NO.:
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APPROVED:
- .,
\PFROVtit. Vi
:*5--,......_ V SUFFOLK CO. TAX MAP DESIGNATION:
DIST. SECT. " BLOCK : PCL.
I 1 -.: -1000 ' -
0.70 -._ - • . -8.' .. --.•' -
1 1
I 1 .
OWNERS ADDRESS:
SCALE ONWCIOD tX2
-40.1
AIZEA.29,2 0,".,•4 F
aiMONitiMELIT—
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1 -7E
-ENGLEWOOD - FLA.34223 - .
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_E13:;475-1665 •
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7''',,,',..t the Nc York State
• '-"c•::::•tion Law.
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