HomeMy WebLinkAboutCusumano, Michele G
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Town Hall, 53095 Main Road
������ P.O. Box 1179
-=41 � � 0.° Southold, New York 11971
JUDITH T.TERRYFAX(516)765-1823
TOWN CLERK TELEPHONE(516)765-1801
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. 624 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PECONIC CESSPOOL
Address 1 : P. O. BOX 972
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
REPLACE EXISTING CESSPOOL WITH NEW TYPE PRECAST.
APPROVED AS SUBMITTED. EXCAVATION INSPECTION REQUIRED. CALL 765-1802
FOR AN APPOINTMENT PRIOR TO COVERING.
Name Of Owner CUSUMANO, MICHELE
Mailing Address 1 P. O. BOX 117
City St Zip NEW SUFFOLK NY 11956
Property Address 1 NEW SUFFOLK LANE
City St Zip NEW SUFFOLK NY 11956
Tax Map No. section 117.00 block 5 lot 32.000
Cross Street ORCHARD STREET
Building Permit Number Cross Reference:
Issue Date: 7/18/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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RECEIVED
JUL 18 199+
low Clerki.+tllflld q R . Town Hall, 53095 Main Road
P.O. Box 1179
( „ Southold, New York 11971
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JUDITH T. TERRY y..iii gr TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
CSC EOVE
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July 10, 1990 ji
JUL I 11990 I i,
To: Southold Town Code Enforcement Officer Y
TOWN OF SOUTHOLD
From: Linda J. Cooper, Southold Town Clerk's Office . ..—J
Transmitted herewith is a copy of application No. A639 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Michele Cusumano
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 - �C
DISAPPROVE -
COMMENTS: .+,4 Jj ..�, �,� **".
*I40 VA'31/44.,C&I-.0=-°L4-afi-•
. ' Signature
1\ k‘\RO
Date
OFFICE OF THE TOWN CLERK ,,,'",,,,,
Town of Southold 1 �FFDLK`', .. f
Town Clerk
Judith T. Terry, �� Dy- Application No.(p�
;
Town Hall, 53095 Main Road ;.,'� 0 Construction
P. O. Box 1179
Southold, New York 11971 t�ts r"l Alteration
V Q
$10.00 - Residential
Telephone =% � , '
(516) 765-1801 - 4' o' $25.00 -Non-Residential ntial
-- „ ..,,, ,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE
APPLICANT NAME: /1.... 491,,e...:C
APPLICANT ADDRESS: .4i j6Z
SEPTIC CESSPOOL .-------
DESCRIPTION
-DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALT?RATION:
OWNER OF PROPERTY: ✓.. 4 7r. sI,/e, .,-
OWNER MAILING ADDRESS: //d, / Z.'J>f 7
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OWNER PROPERTY ADDRESS: - , .. / L'�! ,
TELEPHONE NUMBER OF CONTACT PERSON: lyr-474S2.
TAX MAP NO. : Section f`7 Block .5- Lot 32_ .
CROSS STREET: /fi.,=-if. fPAl/or''' 1--A-
BUILDING PERMIT NUMBER CROSS REFERENCE:
ri€14;04".
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Signature of A.,.`icant
RECEIVED BY:
Town Clerk's Office
DATE:
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