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JUDITH T. TERRY z L . Town Hall, 53095 Main Road
TOWN CLERK , P.O. Box 1 179
REGISTRAR OF VITAL STATISTICS ilk Southold, New York 1 1971
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MARRIAGE OFFICER
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 779 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PECON I C CESSPOOL
Address 1 : P. O. BOX 972
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
ADDITION OF AN OVERFLOW POOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. HOLD 12'0” SEPARTATION AND CALL FOR REQUIRED
EXCAVATION INSPECTION.
Name Of Owner COSENTINO, CONCETTA/DEANGLINA
Mailing Address 1 P. O. BOX 253
City St Zip NEW SUFFOLK NY 11956
Property Address 1 NEW SUFFOLK AVENUE
City St Zip NEW SUFFOLK NY 11956
Tax Map No. section 117.00 block 6 lot 23.000
Cross Street BUNNY ROAD
Building Permit Number Cross Reference:
Issue Date: 12/05/91 Judith T. Terry
Southold Town Clerk
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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK _ P.O. Box 1 179
REGISTRAR OF VITAL STATISTICS T Southold, New York 11971
MARRIAGE OFFICER y Fax (516) 765-1823
Telephone (516) 765-1801
Ala
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
November 25, 1991
To: Southold Town Code Enforcement Officer
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A 801 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Cosentina/DeAnglina
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 - n
COMMENTS: M tS.J. I3.��o .�• 4�t.w1/��M 01.1 .
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�� O��` RECEIVED Signature
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Date
3stcerK.
fim.tti Clerk Soutt old
OFFICE OF THE TOWN CLERK ",,,"
Town of Southoldaxe� Application No. ��
Judith T. Terry, Town Clerk ; Gy
Town Hall, 53095 Main Road ;$ 41 = Construction g--
P. O. Box 1179
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Southold, New York 11971 s cczit'i �'; Alteration
Telephone � ' $10.00 -Residential
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(516) 765-1801 ' l ' $25.00 -Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE 4,01/ 2-0/
APPLICANT NAME: A---0.9ve,c_.
APPLICANT ADDRESS: /Q1 /3 7L
SEPTIC CESSPOOL L�
DESCRIPTION OF ROPOSED CONSTRUCTION OR ALTERATION
T
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY:
OWNER MAILING ADDRESS: / 0 61-1 8)-53
7LI+v /NS/
PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: a-9 -_ `?G Sr
TAX MAP NO. : Section 111 Block CO Lot 23
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
,1
ignature of Applicant
�1
9 pp
RECEIVED BY:
Town Clerk's Office
DATE:
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