HomeMy WebLinkAboutDiSilvio, Michael oo, I�g�fFO(,ic
JUDITH T.TERRY tt_0 ?� Town Hall, 53095 Main Road
TOWN CLERK ; y ? P.O. Box 1179
Pr, I Southold, New York 11971
REGISTRAR OF VITAL STATISTICS %•? ' 1� Fax(516) 765-1823
MARRIAGE OFFICER O".**
RECORDS MANAGEMENT OFFICER 49/ *0606 Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER ,is'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1651 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PECONIC CESSPOOL
Address 1 : P. O. BOX 972
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
ADDITION OF CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS
BUILDINGS, PROPERTY LINES, AND WATER BODIES. EXCAVATION INSPECTION
REQUIRED.
Name Of Owner DISILVIO, MICHAEL
Mailing Address 1 45605 MAIN ROAD
City St Zip SOUTHOLD NY 11971
Property Address 1 45605 MAIN ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 75.00 block 2 lot 13.000
Cross Street HARBOR ROAD
Building Permit Number Cross Reference:
Issue Date: 4/30/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
o„�FFOIIre�ti���
Town Hall, 53095 Main Road
Iii; bi P.O. Box 1179
el ot170 .‘0'' Southold, New York 11971
JUDITH T.TERRY •v“.._ TELEPHONE
(516) 765-1801
TOWN CLERK
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office APR 2 2 1997
DATED: April 21, 1997 .
Transmitted herewith is a copy of application No. 1722 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Mike DiSilvia •
Please review the application and location map and advise if this office may
issue the permit.
Please complete the form below and return it to this office.
Thank you.
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE -
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
•
RECEIVED
S gnatur:
NPR 2 91997
Date
Southold Town Clerk
1
OFFICE OF THE TOWN CLERK ,,,,,,,,,,,,,'- Rol--
Town of Southold .0"Cj�Ff01irc� _ Application No.
�,
Judith T. Terry, Town Clerk Gy
Town Hall, 53095 Main Road Construction L�
P. O. Box 1179 : v T ; Alteration
Southold, New York 11971 ;
Tele hone yO 4`%.. ' $10.00 - Residential
p � �
(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 4/2'//9-7
APPLICANT NAME:
APPLICANT ADDRESS: _ '44 /).0.. ‘ 9,71
SEPTIC CESSPOOL V
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 :
OWNER MAILING ADDRESS: 'S &OS / lAt-A-1-1
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: If 5 F
TAX MAP NO. : Section /5-
Block q Lot /
GR-A-rrs' STREET :
BUILDING PERMIT NUMBER CROSS REFERENCE:
RECEIVED Signature of Appli nt
RECEIVED BY : �Qa
gn2C�le% Office
DATE:
Southold Town-Clerk—
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