HomeMy WebLinkAboutCacioppo, Paul I ,,_ fr_•-
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JUDITH T.TERRY � 0 Gyre Town Hall, 53095 Main Road
TOWN CLERK ; y Z P.O. Box 1179
v. � Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ‘`% t `� #
MARRIAGE OFFICER "=y0( O
Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER . 41( `�►� . Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ••, ,�II���
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1555 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PAUL AND MAUREEN CACIOPPO
Address 1 : 44 WILTON ROAD
City St Zip COLD SPRING HARBOR NY 11724
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. SCHD REF. #R10-95-76
Name Of Owner CACIOPPO, PAUL AND MUAREEN
Mailing Address 1 44 WILTON ROAD
City St Zip COLD SPRING HARBOR NY 11724
Property Address 1 NEW SUFFOLD AVENUE
City St Zip NEW SUFFOLK 0000
Tax Map No. section 116.00 block 3 lot 18.000
Cross Street GRATHWOHL ROAD
Building Permit Number Cross Reference:
Issue Date: 10/08/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
+- • �,�o��gUfFO��co / S $ Y
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JUDITH T.TERRY ��_ ��`� Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS $ Southold,New York 11971
MARRIAGE OFFICER �y ��� Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER =�0.t' `1►� / Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ,•+��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: October 3, 1996
Transmitted herewith is a copy of application No. 1621 for a Cesspool/
Septic Tank Construction Permit submitted by:
Paul and Maureen Cacioppo
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: LLg., a � ',e • .y, I . O .�
RECEIVED
0 CT 7 1996 Signature
Southold Town Cleric Dated
OFFICE OF THE TOWN CLERK to,,,,,,,"''•,,
Town of Southold �.01 �VUL/(
�� �� CQG •
Application No. / C., ) /
Judith T. Terry, Town Clerk l y-..
Town Hall, 53095 Main Road % Construction
P. O. Box 1179 ; ornZ
Southold, New York 11971 . cts 41 Alteration _
Telephone %OA. 4../ $10.00 - Residential '--
(516) 765-1801 =�01 ���� $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE
APPLICANT NAME: az. d4 "9/4/42 6c-tit/ 4p,/o. ____
APPLICANT ADDRESS:4(p. U/L/C2// /9 &)z..CS 3f 0,4 y
l i//01y
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION_- ir
/9 ___OA/Z- f-19'gd/ PZ9117 ..6. baile'LZIA/e; ____
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONST UCTION OR ALTERATION:
OWNER OF PROPERTY: 'at. vwe - J e d e/0,10
OWNER MAILING ADDRESS: T V al/LT R,O .
i o '_ S la,e/ll// /9&,8 y // .
OWNER PROPERTY ADDRESS: /4/ Gel -2 4 9I/
TELEPHONE NUMBER OF CONTACT PERSON: 5/4 567-70_63
TAX MAP NO. : Section //4 Bock cS Lot !
�
- - -
CROSS
. _______ __
CROSS STREET : aE(,�T9_/ _ A
BUILDING PERMIT NUMBER CROSS REFERENCE:
/ . .
/. / 11 14 ) —
Signaturi. Applicant
RECEIVED BY: f' , a- -e--t,k.__(_
Town Clerk's Office
DATE: - / '76:
SUFFOLK CO. HEALTH DEPT. APPROVAL
H.S. NO.1210-95-DC77
`
'Approved woe with Board at Reviver•
.. eterminatten�d ed-JAA Al 9*I 99_1(o
-, tc_ .` c:01'ze'�' F t A,4A.1 OF P4.',..9
.1______E.tZ Tr' STATEMENT OF INTENT
25 cry .lp } THE WATER SUPPLY AND SEWAGF� DISPOSA.
'1. g.P i �.. Ste,"� 52 SUk'vE .Er� �4�' SYSTEMS FOR THIS RESIDENCE WIL.
l S �b �"ZCONFORM TO THE STANDARDS OF TH:
F �6_ i r-'4*-
.''1 UL. s f �,I.JC � a• AC-LQP" O.• SUFFOLK CO. DEPT. OF HEALTH SERVICE=
3 Y; r- �g-6 r''' �1_ — - - 1 I
(S)
i
. A �,1 gB• ��' i -i. ;47' I • APPLICANT
. - .\- �~ /' t ` �' ~ • 1 Nrr' 4�UFf"�". �i SUFFOLK COUNTY ADEPT. OF HEAL.T.
`k 1'Q• / .' .' i,' mac` A - l SERVICES - FOR APPROVAL FC
{. Y r✓ �.J ' :. t .'�, .' �. _ f CONSTRUCTION ONLY
+1 ` J �* f/,i��leisi < _ W T -_ DATE:
` ,\� ti j !J a,•, L Q1� H.S.REF. NO.. e -'95-OD'Ka -
t r _ r_ -I` r. t APPROVED-
.• Jk i a . 1 te+s �P � `T+ r »' }, ' �` `� SUFFOLK CO.TAX MAP DESIGNATJON:
4 t., n '� 1 ' + :;i " 44 4 ._ A • s:. f,:�'7 . Lad.F T . M I DIST. . SECT'- BLOCK PCL.
- T-- � : �. (OA 0:- 116 3,- t8
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