HomeMy WebLinkAboutCanuso, Vicky I ilii��
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JUDITH T.TERRY ����� yet Town Hall, 53095 Main Road
TOWN CLERK ; y = P.O. Box 1179
" � Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER y4, �� �1 Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER lift
'�►a �i� Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER sgi
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1449 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : VICKY E. CANUSO
Address 1 : P. O. BOX 694
City St Zip QUOGUE NY 11959
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. #R10-96-0013
Name Of Owner CANUSO, VICKY E.
Mailing Address 1 P. O. BOX 694
City St Zip QUOGUE NY 11959
Property Address 1 9 ROSEWOOD DRIVE
City St Zip MATTITUCK NY 11952
Tax Map No. section 113.00 block 2 lot 9.000
Cross Street COX NECK ROAD
Building Permit Number Cross Reference:
Issue Date: 4/09/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY • o < Town Hall,53095 Main Road
TOWN CLERK % H Z • P.O.Box 1179
�r0ivySouthold,New York 11971
REGISTRAR OF VITAL STATISTICS O`, '•1 Fax(516)765-1823
MARRIAGE OFFICER -v� �1 Telephone(516)765 1800
RECORDS MANAGEMENT OFFICER 1 ���
FREEDOM OF INFORMATION OFFICER �..�•, /fr
ii'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: March 19, 1996
Transmitted herewith is a copy of application No. 1508 for a Cesspool/
Septic Tank Construction Permit submitted by:
Vicky E. Canuso •
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
RECENEDnts: `1-4(/" SG�//, 4:' 4
/
APR 9 1996
Town Clerk Southold
Signatur
gM
Dated
OFFICE OF THE TOWN CLERK , ,,""""••.,
Town of Southold ..11. �F U1.er
Town Clerk �` �� Ol/ Application No. /.37°
Judith T. Terry, � y
Town Hall, 53095 Main Road Construction
P. 0. Box 1179
Southold, New York 11971 �t1') Alteration
Telephone ` ,y ��Q�''�`� $10.00 - Residential V
(516) 765-1801 _ 1 ' $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. •
Fee .$
DATE
APPLICANT NAME: 'vac\Ly � . (-) U 30
APPLICANT ADDRESS: T,° �o� CoSL\
SEPTIC CESSPOOL V
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION }sew
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 'k ,y\
OWNER MAILING ADDRESS:- .0 . (,OL
v D \) N '1'. \ .a5°1
OWNER PROPERTY ADDRESS: q LS,Q,v,,00e " S:)rw"k___
o.`�'\\kv..c,\c.
TELEPHONE NUMBER OF CONTACT PERSON: 61‘ C053 (A6.1-IS
TAX MAP NO. : Section\coo- \\3 Block 6'-- Lot 6CA
CROSS STREET: C,tyy„ N e,��L,"d
BUILDING PERMIT NUMBER CROSS REFERENCE:
--)Nc\ -.NS.)•k-c\,), 1-2,sfs--
Si. .ature of Applicant
RECEIVED BY: /C114
Town Clerk Office
DATE: -/ / 9/9,6
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II 4 I I iE MINIMUM
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f) ECTABLISIIED
I AND ADOPT FD
')RK STATE !AND
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
mbar Fon APPROVAL OF CONSTRUCTION FOR A
SINGLE FAM/LY RESIDENCE 01,7_
FEB 1 6 1996
DATE liS
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APPROVE" 4
OR A,LAX/MUM OF BEM. -US
I.U,TTIZES,THREE YEARS FM D.3.T11.OF APPROVAL
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