HomeMy WebLinkAboutPappacoda '/,/i/1111
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• ELIZABETH A.NEVILLE �� � Town Hall, 53095 Main Road
TOWN CLEI$Ka P.O. Box 1179
v, Southold, New York 11971
REGISTRAR,OF VITAL STATISTICS `o� �yC,/�� Fax(631) 765-6145
MARRIAGE OFFICER ,L
RECORDS MANAGEMENT OFFICER "'/®1 **a® � Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ,�, ��, r�'� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2853 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JEFFREY BUTLER
Address 1 : PO BOX 634
City St Zip SHOREHAM NY 11786
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 #R10-02-0098
Name Of Owner PAPPACODA, FRANK
Mailing Address 1 547 KIME AVENUE
City St Zip WEST ISLIP NY 0000
Property Address 1 LAUREL LINKS
City St Zip LAUREL NY 11948
Tax Map No. section 125.00 block 4 lot 24.010
Cross Street
Building Permit Number Cross Reference:
Issue Date: 7/23/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE pis�� * Town Hall, 53095 Main Road
TOWN CLERK % ® - % P.O. Box 1179
REGISTRAR OF VITAL STATISTICS n1 i Southold, New York 11971
MARRIAGE OFFICER
® �°����� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER =__4 all %•." Telephone (631) 765-1800
F INFORMATION OFFICER ������,,���� southoldtown.northfork.net
iL I JUL 15 2002 / ill
OFFICE OF OWN THE TOWN
CLERK
LTGlii:i ,ft .eit•iy0
_______s_„ag
TO: own Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: July 12, 2002
Transmitted herewith is a copy of application No. 2958 for a Cesspool/Septic Tank Construction
Permit submitted by:
Jeffrey T. Butler
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
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Signature
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OFFICE OF TEE TOWN CLERK •.,,,•,•••••••,,,
ELIZABETTHAOFSOUF,HTOWNCLERx .`�TOLD � S�FFOt"4 _• Application No.e2f'1
P.O.BOX 1179
SOUTHOLD,NEW YORK 11971 ;
Construction 17
c • Alteration
Telephone deiff
�' $10.00 -Residential
(631) 765-1800 1. *�,,r $25.00 -Non-Residential
TOWN OF SOUTHOLD •
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee •$
DATE -2l�--L�2-
APPLICANT NAME: U �, 4oFLE1
APPLICANT ADDRESS: / :U ',a..? 6-4V
c97` E.p'o �v
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:
OWNER OF PROPERTY: •�,//yz. "00,4 va,49'
OWNER MAILING ADDRESS: S-\'-7 A.151
OWNER PROPERTY ADDRESS: Z� 415 1Ij L/111 ��•
Z a,,edz A. 12.
TELEPHONE NUMBER OF CONTACT PERSON: `$tea /- ?7S-Z)
TAX MAP NO. : Section /Z Block y Lot ? 1,/.0
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
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fp" - • Applicant
RECEIVED BY
I Town Clerk's Office
DATE: 111 2,L C7��
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PT = MOM IUFNT SFT ■ = NONUMFNT FOUND A = STAKF SFT A= STAKE FOUND VII= TELEPHONE BOX 0 WM = WATER METER 0 MV = WATER VALVE