HomeMy WebLinkAboutCacioppo, Joseph (2) t
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 3304 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : PECONIC CESSPOOL
Address 1: PO BOX 972
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
ALTERATION/ADDITION TO EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS
BUILDINGS, PROPERTY LINES AND WATER BODIES.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner CACIOPPO, JOSEPH
Mailing Address 1 1835 PARK AVENUE
City St Zip MATTITUCK NY 11952
Property Address 1 1835 PARK AVENUE
City St Zip MATTITUCK NY 11952
Tax Map No. section 123.00 block 2 lot 34.000
Cross Street
Building Permit Number Cross Reference:
Issue Date: 5/18/05 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
••
'\pF S004,- 33o
•ELIZABETH A. NEVILLE ,�', l'
��� �l ; Town Hall, 53095 Main Road
TOWN CLERK , Q 4 , P.O. Box 1179
REGISTRAR OF VITAL STATISTICS % u, 4c Southold, New York 11971
MARRIAGE OFFICER % Fax�1�� Fax (631) 765-6145
REL.hi,�ll,. A'E�{E $' 6! F * `- Ol� �` -••e Telephone (631) 765-1800
FREEDOM FQ tMA 1 R -: COU , Ise southoldtown.northfork.net
Ir
OFFICE OF THE TOWN CLERK '! ,
----b j,—, urFr TOWN OF SOUTHOLD ! `. MAR ^005 I I.j
TO: Southold Town BuildingDepartment ops'. r
p _ ''C'NN fig :�^ ���c' __
FROM: Linda J. Cooper, Southold Town Clerk's Office
Lita
DATED: ,
4-1 Icy Q, -Alavyt
Transmitted herewith is a copy of application No. 3448A for a Cesspool/Septic Tank ALTERATION
Permit submitted by:
Peconic Cesspool for Joseph 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.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommend. .: .
APPROVE
DISAPPROVE ✓ /% t� 4,..„=„4„. a
Comments: Maintain required setbacks from adjacent wells, buildings, property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED. .
2 .(44....4-e.0"
Signature
‘,. //10,4,,,Z 0-49/ ploos_
avt=4....do)
Dated l
vC,e tea_ ram.4......0,64,156)
rl++ , ,
OFFItB OF'tLB'[U1VN CLERK ��+
qfU[ke
TOWN OFSOUTHOLO 0''n') Q Application No.
ELIZABETH A.NEVItLI,TOWN MIRK G�' Z t
P.o.BOX1179 =� Construction 4/
SOUTIIOLD,NEW YORK 11971 "pc,t Alteration
Telephone `1.4°,y� ar ,
$10.00 Residential(631) 765-1800 = Ol ';+r+ $25.00 Non-Residential
•
TOWN 01: SOUTIIOLD
SOUTIIOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCT ION or ALTERAT ION PERM If
SEPTIC TANK or CESSPOOL
Permit No. 34LI$4
Fee .$
DATE 5-
APPLICANT NAME: PECONIC CESSPOOL
APPLICANT ADDRESS: P. O. BOX 972
MAT1'ITUCK, NEW YORK 11952
SEPTIC f/ CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
a.Ae lie + ,
LOCATION MAP: Must be attached hereto before I)9rmit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTL.RAT!RN:
OWNER OF PROPERTY: �, �z'-1 /9,;z&•kt Jr.)
OWNER MAILING ADDRESS: / '3ç
OWNER PROPERTY ADDRESS: c52i72.. -
TELEPHONE NUMBER OF CONTACT PERSON: k. f(.05
TAX MAP NO. : Section / 23 Block e - Lot ,'3 .se f _
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFER' ICI::
Siyl1alure of Appl• a►1
11
RECEIVED BY:1/',•
Town Cfer'k1s Office
DATE: •
:01/ro
/0-r-2) ti /2i b--L, z La —51c
) J
.
r•�
-4_ ate-.
I
`' t GA"
4
c,
; ,. by
l phi, ,
,,
.4 , 4, ,P
,'/fp,
` � -
' N,}..T . 4'
ict 014 vi /
pit
OP
/ • c_c75 p°°t'
w
V V
JOSEPH CACIOPP.O
1835 PARK AVENUE
MATTITUCK
.ke 1SIS-'-L
P,5 w,- s
14,A----i---.! (.....p"-- -ke--;--N eg. )
K
'.'w a. 1 tt LL I :