HomeMy WebLinkAboutBucci, John oit etFFOLit
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JUDITH T.TERRY 1 = Gym'4 Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
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�y t Southold, New York 11971
REGISTRAR OF VITAL STATISTICS � Fax (516) 765-1823
MARRIAGE OFFICER %�O y� 0����
RECORDS MANAGEMENT OFFICER 0,� . -� Telephone (516) 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. 1714 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : SEA BREEZE CESSPOOL
Address 1 : P. O. BOX 156
City St Zip CUTCHOGUE NY 11935
Descripton of Proposed Construction or Alteration
ADDITION OF CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM WELLS,
BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTION
REQUIRED.
Name Of Owner BUCCI, JOHN
Mailing Address 1 PARADISE SHORE
City St Zip SOUTHOLD NY 11971
Property Address 1 PARADISE SHORE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 80. block lot 22
L1-
Cross Street
Building Permit Number Cross Reference:
Issue Date: 8/15/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY �� 'yam Town Hall, 53095 Main Road
TOWN CLERK o < P.O. Box 1179
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Southold, New York 11971
REGISTRAR OF VITAL STATISTICS V O � ', Fax (516) 765-1823
MARRIAGE OFFICER ��y 1�
RECORDS MANAGEMENT OFFICER = 0,( �aOi Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER = ,,i���
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD 3cr7
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: August 13, 1997
Transmitted herewith is a copy of application No. 1784 for a Cesspool/
Septic Tank Construction Permit submitted by:
SP2 Breeze for John Bucci
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:
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Dated
OFFICE 'OF THE TOWN CLERK � ,,,,'",,,"
Town of Southold ,.' 1c5�FFOIKc-0" / 7 L i
Judith T. Terry, Town Clerk ;' ' ► Application No.
Town Hall, 53095 Main Road ;'z`; Construction
P. O. Box 1179 : v Alteration
Southold, New York 11971 ;Ws W
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_I. � i $10.00 - Residential
Telephone 0l �, o
(516) 765-1801 $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 r _____. ____-
_ _
1 a i
APPLICANT NAME: ,I!,, 1► __/ - I.,ib ,_lit ,�. ! ._ wi < �GJ)raaS
APPLICANT ADDRESS: r 1 /�� '� / J �► � I ,.i�� -d /s_ __
SEPTIC CESSPOOL
DESCRIPTION OF rOPOSED CONSTRUCTION OR ALTERATION �..4_�� - _
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONST UCT I ,N OR ALT •BRAT ION: 1 (
OWNER OF PROPERTY : '�anitvORM , ���,,j 0 _Lelia 4e 1-. .i 1
OWNER MAILING ADDRESS: , ) 4 ,• - A ' _4 w� „A� .
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OWNER PROPERTY ADDRESS: ll
____.______________ ____. s —
TELEPHONE NUMBER OF CONTACT PERSON: 1%,__ 3 37/�—
TAX MAP NO. : Section Block Lot
CROSS STREET :
BUILDING PERMIT NUMBER CROSS REFERENCE:
1 , , -
4. 4 �t
ignature of Applicant
RECEIVED BY :
Town Clerk's Office
DATE: RECFNEn
AUG 131997
town Clerk Southold
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