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Home My WebLink AboutPagano, Joseph 4 o�Og13FFOI,�co ELIZABETH A. NEVILLE �� Gy� Town Hall, 53095 Main Road TOWN CLERK CIO P.O. Box 1179 REGISTRAR.OF VITAL STATISTICS 0Southold, New York 11971 MARRIAGE OFFICER y �� Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER '�O,( �� 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. 3136 R Residential X Non-Residential Fee $ 10.00 septic X Cesspool PERMIT ISSUED TO: Name : PETER DENICOLA Address 1: 1695 CHABLIS PATH City St zip SOUTHOLD NY 11971 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 #R10-03-0036 Name of owner PAGANO, JOSEPH ------------------------------ Mailing Address 1 PO BOX 841 ------------------------------ ------------------------------ City St zip 0000 -------------------- -- ---------- Property Address 1 1345 EAST GILLETTE DRIVE ------------------------------ ------------------------------ City St zip EAST MARION NY 11939 -------------------- -- ---------- Tax Map No. section 38.00 block 4 lot 21.000 ------ --- ------ Cross Street CLEAVES POINT ROAD ------------------------------ Building Permit Number Cross Reference: ---------------------------------- Issue Date: 1/29/04 Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) os�FFot�.�, 34� o•, o� ELIZABETH A.NEVILLE _� y� Town Hall, 53095 Main Road TOWN CLERK co P.O. Box 1179 REGISTRAR,OF VITAL STATISTICS 0-0 Southold, New York 11971 MARRIAGE OFFICER y O�� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER -7�( .�� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net OFFICE OF THE TOWN CLERK t 420 TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: January 8, 2004 Transmitted herewith is a copy of application No. 3273 for a Cesspool/Septic Tank Construction Permit submitted by: Peter DeNicola for Joseph Pagano 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. Linda J. Cooper I have reviewed the application and location map of the project cited above and make the following recommendations: / APPROVE ✓/ DISAPPROVE Comments: i Signature dI / 7 Dated � • k o�Oc,�FFO�xc ELIZABETH A. NEVILLE h`Z` �G.y Town Hail, 53095 Main Road TOWN CLERK P.O. Box 1179 y = Southold, New York 11971 REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER O , � � 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 Residenti @ $10 or Non-Residential @ $25 Application No. 3a� Permit No. Z7 ?Applicant Name Applicant Mailing Address ✓3 h S ?4 Seu�} 1.O UD It-4 !1 Septic Tank --"or Cesspool Brief Description of Proposed Construction or Alteration ��i9�.ti,D a� ��RLj-� ��,J�•,e►�• •,�a+L ►"-�+�� w S��•c�e c� Location of Proposed Construction/Alteration: Owner of Property: :3��r_P Owner Mailing Address: ?d l3o�C g'y 1 Owner Property Address:N3PA5 Ea"+ Rar t0A Name and phone number of contact person �-VerL_ \',)e Lots 7 tom-j 3b� Tax Map No: Section e�> DDBll'ock &'l Lot 2/ Cross Street C.keai PS f �-d - NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL i og o Sign ture of Applicant Date Received by. 'r O SURVEY OF PROPERTY. A T EAST MARION TOWN OF SO UTHOLD SUFFOLK COUNTY, N. Y, 1000--36-04--21 SCA LE. 1'=30' OCT. 23, 2002 NOV. 4, 2002 ( Test Hole ) ^) NOV. Il, 2002 (prop. hse. I r 6F 'pop i 6 f r -rop v a v LOT NUMBERS REF&9,10 "MAP OF MARION kf n � FILED I '�F K COUNTY CLERK'S 1 OFFICE ON , ` S FILE NO. 2038. o h� Z d LZ 03 tat' , Y. . LIC. NO. 4".18, C S ta,vV (6 _ p° (631) 765-1797 5 ami,"64—A. P.O. SVQ` N joG TEST HOLE <OO" Brown Soy tond SM ��?� +t4 Pde brown �5 a the to coarse sand swy el 6.3 9.71 1W 4� r water h pats bre" Br» to cows. Sand sw 00-0 Q / �`0 01 I am familiar with the STANDARDS FOR APPROVAL AND CONSTRUCTION OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES and will abide by the conditions sept forth therein and on the �5! permit to construct. The location of wells and cesspools shown' 17ereon are from field observations and or from data obtained from others. ANY AL7ERA77ON OR ADD177ON TO 7H/5 SURVEY /S A VIOLATION OF SEC77ON 7209 OF THE NEW YORK STATE EDUCATION LAW. EXCEPT AS PER SEC77ON 7209-SU8010SION 2. ALL CER77FICA77ONS HEREON ARE VALID FOR THIS MAP AND COPIES 1NEREOF ONLY IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURWYOR WHOSE SIGNATURE APPEARS HEREON. ELEVATIONS REFERENCED TO AN ASSUMED DATUM.