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Home My WebLink AboutMilazzo, John o��S�FFO�,�coG ELIZABETH A.NEVILLE _� '�� Town Hall, 53095 Main Road TOWN CLERK H P.O. Box 1179 REGISTRAR OF VITAL STATISTICS �y� • �� Southold, New York 11971 MARRIAGE OFFICER Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER �,� .�� Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER 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. 3122 R Residential X Non-Residential Fee $ 10.00 septic x Cesspool PERMIT ISSUED TO: Name : JEFFREY T. BUTLER Address 1: PO Box 634 City St Zip SHOREHAM NY 11786 Descripton of Proposed construction or Alteration SANITARY SYSTEM FOR ONE FAMILY DWELLING. APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES. REF #R10-03-0032 t;ame Of Owner MILAZZO, JOHN ------------------------------ Mailing Address 1 137 KINGS ROAD ------------------------------ ------------------------------ City St Zip HAUPPAUGE NY 11788 -------------------- -- ---------- Property Address 1 690 BROOKS ROAD ------------------------------ ------------------------------ City St Zip GREENPORT NY 11944 -------------------- -- ---------- Tax Map No. section 53.00 block 1 lot 9.000 Cross Street MAIN ROAD ------------------------------ Building Permit Number Cross Reference: ---------------------------------- Issue Date: 1/29/04 Elizabeth A. Neville -------- Southold Town clerk (TOWN SEAL) gFF01. ELIZABETH A. NEVILLE Town Hall, 53095 Main Road TOWN CLERK CA Z P.O. Box 1179 REGISTRAR,OF VITAL STATISTICS W- • Southold, New York 11971 MARRIAGE OFFICER O Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER Ol �� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net OFFICE OF THE TOWN CLERK g '�1 TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: November 19, 2003 RE: Cesspool Construction Application Transmitted herewith is a copy of application No. 3257 for a Cesspool/Septic Tank Construction Permit submitted by: Jeffrey Butler for iohn Milazzo 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 me. Thank you. * * * * * * * * * * * * I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE DISAPPROVE Comments: 01 Signature Dated ti ELIZABETH A.NEVILLE h`t`� �G�y Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 cooREGISTRAR OF VITAL STATISTICS V. Z Southold, New York 11971 MARRIAGE OFFICER Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER O'� �a southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential @ $10 i/ or Non-Residential @ $25 Application No. Permit No. Applicant Name >' fZ- Applicant Mailing Address Septic Tank or Cesspool Brief Description of Proposed Construction or Alteration /�b✓ 6 ,—. Location of Proposed Construction/Alteration: Owner of Property: owls Owner Mailing Address: i 3 7 ��s �o AO Owner Property Address: 7-- Name Name and phone number of contact person 6 3 —2 — ?3e:�g Tax Map No: Section S 3 Block 6 Lot Cross Street NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL Sign ure o scant Date Received by: � �� r {y4� MOJECT DESCRIPTION: 9 0 WT a Pf 1pew�a MOLE FAMILY FOLK COUNTY DEPARTMENT OF HEALTH SERVICES R�St�I+rlr� DRooM- l^IATEfK"�Upl': 1 PERMIT WOR APPROVAL OP'CONSTRUCTION FOR A PIPM CREEK O (XkY RESIDENCCE ONLY 0A J HSPM.NO BOUT HOLD ' A i APPLICANT RAME: � -K')FK P. MIR0� d R05E L. MILAZZOwe= Is�owtc 77T4l�o�rA� HAl1PPA )eE, NY 1178& DATE PREPARED: �-y000 866 ATTACHIrD SPECIAL C DITION �'� GMING PLAN AN LOT PLAN �0a Reference#R10-03-32,MilazzO I AL SPECIAL CONDITIONS OF APPROV I, The installation of the sewage disposal system and retaining Fall must be supervised and certified b a licensed design professional(Form W"-073 enclosed). y ailing and drainage. Permit and plan is subject to approval by the Town of Southold for gr 2. This perm �..u.� li,' i�lii .��6�J Ii ��, I'. ilJc. 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ER 1 �� Q' f �r (/ � � �K\\)II i^EETLANDS ✓i �W� '^i f' , \`' ��'� /\�1 otcc` --- \ c �� 4)0 /\ •��( `` Thl�tq ;LP ' x IDAL WE-LANDS BOUNDAR --- 1 gw- \ �`J�! dt ' /' ' �� i DELINEATED BY JEFFRE SEEMAN OF COASTAL 3,_ �_ _.. :. �" .�\ � �\,� � �.._._`� �� %� EN'v'IRUNMENTAL CORPORA %.N JUNE 25, Iggq 4 `VERIFIEC LORENGE CN FEBRUARY 12, F - r • 4 ti ..SAr Cf 50 IZF C,} J \ N