HomeMy WebLinkAboutBrisotti, Albert JUDITH T. TERRY : y`• Town Hall, 53095 Main Road
TOWN CLERK : o •
T P.O. Box 1179
On Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = Fax (516) 765-1823
MARRIAGE OFFICER k, ,P Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER - *
FREEDOM OF INFORMATION OFFICER ,i,,,�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1081 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : ALBERT BRISOTTI
Address 1 : OLE JULE LANE
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
ADDITION OF AN OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS AND PROPERTY LINES. EXCAVATION INSPECTION REQUIRED.
CALL THE BUILDING DEPARTMENT (765-1802) TO ARRANGE INSPECTION.
Name Of Owner BRISOTTI, ALBERT
Mailing Address 1 OLE JULE LANE
City St Zip MATTITUCK NY 11952
Property Address 1 OLE JULE LANE
City St Zip MATTITUCK NY 11952
Tax Map No. section 122.00 block 4 lot 35.000
Cross Street KRAUS ROAD
Building Permit Number Cross Reference:
Issue Date: 12/23/93 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
X06/
if i.c)tf OIXA -. /46( CS)
JUDITH T. TERRY : Z < ; Town Hall, 53095 Main Road
TOWN CLERK =v T P.O. Box 1179
to . � Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = % �. ��� Fax (516) 765-1823
MARRIAGE OFFICER '_.�/�„ �A �s Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER _ 1 + ..
FREEDOM OF INFORMATION OFFICER = ..,,,,lllill�l
OFFICE OF THE TOWN CLER14`)�1 { LE- '`'
TOWN OF SOUTHOLD
. DEC 16199(3
is I
TO: Southold Town Building Department j --
FROM: Linda J. Cooper, Southold Town Clerk's Ofrt+ FFSou
DATED: December 16, 1993
Transmitted herewith is a copy of application No. A1116 for a Cesspool/
Septic Tank Construction Permit submitted by:
Raymond Nine for Albert Brisotti ,
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 ✓ iNSpEv'ION
aCMIKIVN RED
DISAPPROVE R,./ .,//f if E U�
Comments•
. � �� ���� ,-,
‘2•C/20P-c.4-0// leiv.e.-‘4, . ,49:. ".., --- .., / -
'Z' 9''''
'41' Signatu�f
DEC 22 1993
/2/2-•2/93
tom, Dated
OFFICE OF THE TOWN CLERK ,��'"���""''--
Town of Southold �'' c§tf ices;-=
Judith T. Terry, Town Clerk O/y=. Application No. l /‘.,
Town Hall, 53095 Main Road � Construction
P. O. Box 1179
Southold, New York 11971 �'�; Alteration
Telephone 765-1801O ����� $10.00 - Residential 710i�
(516) l IP'�
- 4. ' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. //
Fee $ ('(j ----
DATE P2/ i6 / �j 3
APPLICANT NAME: 19L gE fir g /p f'd rj'/
APPLICANT ADDRESS: CLQ J til Lt L r9iv
fr-r7 14T7 f 7 y�fi , /1/y it 952
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
1S-1 w i' po /AT Bite f
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ri Ise 77"/
OWNER MAILING ADDRESS: CL
>"► � 77 (7ryc; J-. //q
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section Block Lot -- .3
CROSS STREET: ij'S 4 (,i
BUILDING PERMIT NUMBER CROSS REFERENCE:
L,ti6 (-
Signature of Applicant
RECEIVED BY: 264/
L4-2-)_-r-w
Town Clerk's Offfice
DATE: / / /c/9-
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