HomeMy WebLinkAboutJoffe ELIZABETH A.NEVILLE �lCPO'd: Town Hall, 53095 Main Road
TOWN CLERK ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �� �tFax(631) 765-6145
'�� Southold, New York 11971
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER � V ,,ss22,, �� ��i� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER `u' ��
OFFICE OF THE TOWN CLERK
SOUTHOLD VASTEIVASCIERTHIXIMOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2604 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL
Address 1 : 2760 YENNECOT DRIVE
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
ADDITION TO EXISTING SYSTEM.AMILY DWELLING.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner JOFFE, SIMEON
Mailing Address 1 60015 MAIN ROAD
City St Zip SOUTHOLD NY 11971
Property Address 1 60015 MAIN ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 56.00 block 3 lot 10.000
Cross Street
Building Permit Number Cross Reference:
Issue Date: 6/27/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE �$1_� y�: Town / 0260y
H:.0,-53095 Main Road
TOWN CLERK
$ P.O.Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER :O�i ` /', Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ®1 *01°
Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER s,s' -
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
•
DATED: June 12, 2001 •
Transmitted herewith is a copy of application No. 2693 for a Cesspool/Septic Tank Construction'Permit
submitted by: - -
Simeon Joffe
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: ' V •
APPROVE
DISAPPROVE
Comments:
Signature
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Dated- .
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•
OFFICE OF THE TOWN CLERIC ,,*CO
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TOWN OF SOUTHOLD ,��®®� CQApplication No. P093
FT d7ABETH A.NEVILT.F,TOWN CLERK �. _4_4%
P.O.BOX 1179 Construction
SOUTHOLD,NEW YORK 11971 T
Alteration
Telephone �� ezr $10.00 - Residential
V
(631) 765-1800 = ®l �,
, $25.00 -Non-Residential
.._, ,,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION'
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE /2 0 /
APPLICANT NAME: - A ccw.ce,f )47 j!4(,�`----
APPLICANT ADDRESS: 966 // XX/V,4:Co PC .A(
SEPTIC CESSPOOL
DESCRIPTION OF R POSED CONSTRUCTION OR ALTERATION
•
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY:
OWNER MAILING ADDRESS: 0®/.5-- 411 1(9
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 7C'i�
TAX MAP NO. : Section 16 Block 3 Lot /6
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
04 7/%771
4z__ E_A2,74 Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE: ( ( 1a
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