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ELIZABETH A.NEVILLE �� Town Hall, 53095 Main Road
TOWN CLERK ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS 410 Southold, New York 11971
MARRIAGE OFFICER 4/4 / Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER -__ ®� Jig • X06 Telephone (631) 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. 2514 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : HARBORV I EW HOMES INC
Address 1 : 1706 NORTH HIGHWAY
City St Zip SOUTHAMPTON NY 11968
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 #R10-01-0042
Name Of Owner HALIKIAS, ROBERT
Mailing Address 1 2101 BROWN STREET
City St Zip BROOKLYN NY 11229
Property Address 1 33595 MAIN ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 97.00 block 1 lot 7.000
Cross Street COX LANE
Building Permit Number Cross Reference:
Issue Date: 2/21/01 Elizabeth A. Neville
Southold Town Clerk
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(TOWN SEAL)
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ELIZABETH A.NEVILLE 0 tA : Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS elv
/�� Southold, New York 11971
MARRIAGE OFFICER ,: �� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER =_ ®1 •®��i� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: February 15, 2001
Transmitted herewith is a copy of application No. 2602 for a Cesspool/Septic Tank Construction
Permit submitted by:
Harborview Homes,Inc. for Robert D. Halikian
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.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments:
ignature
4i$1/ot
Dated
OFFICE OF THE TOWN CLERK ,,,,,,
Town of Southold ofstC��FFDUre
Judith T. Terry, Town Clerk
t• o zn. Ql/ Application No.a6e)
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Town Hall, 53095 Main Road ; 'x E. Construction 4
P. O. Box 1179 '' '�
o � .• :qty,` ^' � Alteration
Southold, New York 11971 ;� .
Telephone ;yam Q�'�e $10.00 - Residential I_
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(516) 765-1801 01 1 �e• $25.00 - Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE
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APPLICANT NAME: iTidA./(..-e-i4,i—rzt,c)
APPLICANT ADDRESS: / 7 d 6 c7,
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SEPTIC CESSPOOL
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DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONS RUCTION ORALTER TIO
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OWNER OF PROPERTY: J,
OWNER MAILING ADDRESS: C / 167_45h
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/ /OWNER PROPERTY ADDRESS: F ✓ �
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TELEPHONE NUMBER OF CONTACT PERSON: 7— O77j,
TAX MAP NO. : Section 77 Block Lot 7
CROSS STREET: C-f./2G-
BUILDING
PERMIT NUMBER CROSS Rd ERENCE:
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/ Sign: e of Applicant
RECEIVED BY : /Ll
LCA-1_,e,i
Town Clerk' Office
DATE: cef17,5 p
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1. SUFFOLK COUNTY DEPARTMENT OF HEALT U SERVICES '
rr� o PERMIT FOR APPROVAL OF CONSTRUCTION FORA
aZ SINGLE FAMILY RESIDENCE ONLY
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JAMES DIXON GANBE ASSOCIATES, INC. o• 0 o o
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