HomeMy WebLinkAboutCipitelli Brothers •
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G+'0�o TT ' Town Hall, 53095 Main Road
it isel P.O. Box 1179
1 �w .. Southold, New York 11971
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JUDITH T.TERRY =''.,,,.i,01'-0FAX(516)765-1823
TELEPHONE(516)765-1801
TOWN CLERK
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 617 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : WARD ASSOCIATES, P.C.
Address 1 : 1500 LAKELAND AVENUE
City St Zip BOHEMIA NY 11716
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 12/23/89.
Name Of Owner CIPITELLI BROTHERS
Mailing Address 1 175-16 LIBERTY AVENUE
City St Zip JAMAICA NY 11433
Property Address 1 PETTY'S DRIVE
City St Zip ORIENT NY 11948
Tax Map No. section 14.00 block 2 lot 24.000
Cross Street BIGHT ROAD
Building Permit Number Cross Reference:
Issue Date: 6/06/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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BL • DEPT.OLD VI i v.= ::_ 0: Town Hall, 53095 Main Road
-J V. ' • P.O. Box 1179
_ � �It _®�� Southold, New York 11971
JUDITH T.TERRY awe i TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Southold Town Code Enforcement Officer
From: Linda Cooper, Southold Town Clerk's Office
Dated: May 30, 1990
Transmitted herewith is a copy of application No. 632 for a Cesspool/
Septic Tank Construction Permit submitted by:
Ward Associates P.C. for Cipitelli Brothers
•
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 X
DISAPPROVE
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RECEIVED 4A''"' I9Y, SL
Signature
JUN Ob 19J /3! l qD
WO awl Southold Dated
OFFICE OF THE TOWN CLERK rOFOU'"
Town of Southold . ��� �ot �Gy� Application No. �3�--
Judith T. Terry, Town Clerk ;` j
Town Hall, 53095 Main Road ` Construction
P. O. Box 1179 0 *'$ Alteration
Southold, New York 11971 0)-"
Telephone [ Residential
(516) 765-1801 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE pal i ci 9
APPLICANT NAME: ' J a_,r cl J oc €` e
APPLICANT ADDRESS:- 1500 L e e Jo-� d 'qv ,
60h N. Y
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
New o�e_- -- c Iy res;cce
LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: C 't, II ,' (�(q-flee'S
OWNER MAILING ADDRESS: U
-TraaI y'
m Qcrt�► s G�- 1 �J�
OWNER PROPERTY ADDRESS: retty Dr, ✓�
Or►ewt I\)•
TELEPHONE NUMBER OF CONTACT PERSON: 5g- ,5',K3 - 1-1-goo
TAX MAP NO. : Section 0 ) LI- Block A Lot f
CROSS STREET: f; '
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BUILDING PERMIT NUMBER CROSS REFERENCE:
C
Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
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