HomeMy WebLinkAboutDiCarlo, Michael Otte.
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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK : o nZ+ : P.O. Box 1179
tr Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = ''0 Fax (516) 765-1823
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MARRIAGE OFFICER //���� � '' Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER ' /1 * 0i.
FREEDOM OF INFORMATION OFFICER iiiii,
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1129 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
ADDITION OF AN OVERFLOW CESSPOOL TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED DISTANCES FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES, AND WATER BODIES. EXCAVATION
INSPECTION REQUIRED.
Name Of Owner DICARLO, MICHAEL
Mailing Address 1 29 COTTONTAIL ROAD
City St Zip MELVILLE NY 11747
Property Address 1 1035 CALVES NECK RAOD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 63.00 block 7 lot 32.000
Cross Street YOUNGS AVENUE
Building Permit Number Cross Reference:
Issue Date: 5/11/94 Judith T. Terry
Southold Town Clerk
(TOWN SEALI---
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JUDITH T. TERRY ; ''� t Town Hall, 53095 Main Road
TOWN CLERK : O T P.O. Box 1179
REGISTRAR OF VITAL STATISTICS � Southold, New York 11971
MARRIAGE OFFICER = •
�0� �6. a No"s�� Fax Tel ph ne16)(516)5-1823
765-1801
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OFFICE OF THE TOWN CLERK
7) N TOWN OF SOUTHOLD titir
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: May 4, 1994 N OF'
SO(�OLD
•
Transmitted herewith is a copy of application No. A1168 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Michael DiCarla ,
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.
4c
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - ' EXCAVATION INSPECTION
DISAPPROVE - REQUIRED
COMMENTS: :.«i„u t i_ . __- - , 4e___...-.„ ...,u Citi , ,« i
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S .natur •
MAY 1 ; 1994L)/
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town Clerk Southold Date
OF1ICt+OF THE TOWN CLERK ,''''''''''
Town of Southold .10. �FFOUref Me-
Town
Judith T. Terry, Town Clerk ; �� . Application No.
Hall, 53095 Main Road ; 41Construction
P. O. Box 1179 'c
Southold, New York 11971 cts ; Alteration
Telephone _1., $b •' $10.00 - Residential
(516) 765-1801 = 1 ,, '' $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE 5—/ 5'
/
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APPLICANT NAME:
�7u
APPLICANT ADDRESS: 11 1 �72
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SEPTIC CESSPOOL L/
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 ALTERATION:
OWNER OF PROPERTY: 7.2,6,-.,
OWNER MAILING ADDRESS:
- p- // 7 C
OWNER PROPERTY ADDRESS: /(;)
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section 4' 3 Block 7 Lot 3
eftOSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
X1,1e
Signatu6 of Applicant
RECEIVED BY: Z �' ,i i
own C -rk's Office
DATE:
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