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JUDITH T.TERRY • tA Town Hall, 53095 Main Road
TOWN CLERK ; g ; P.O. Box 1179
P§v Southold,New York 11971
REGISTRAR OF VITAL STATISTICS
Fax(516) 765-1823
MARRIAGE OFFICER1�
RECORDS MANAGEMENT OFFICER �_� / V,,e/�f
Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER ,.0'/
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1779 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JOHN SCARAMUCCI
Address 1 : P. O. BOX 1403
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES.
Name Of Owner REEVE, NANCY
Mailing Address 1 MAIN ROAD
City St Zip MATTITUCK NY 11952
Property Address 1 CAMP MINEOLA ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 123.00 block 6 lot 1 .000
Cross Street KRAUS ROAD
Building Permit Number Cross Reference:
Issue Date: 12/15/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFOUr
,lOff' c
JUDITH T.TERRY 1% 0 y� Town Hall, 53095 Main Road
TOWN CLERK ` vy _ P.O. Box 1179
v Southold,New York 11971
REGISTRAR OF VITAL STATISTICS V
?i `�I� Fax(516) 765-1823
MARRIAGE OFFICER �_ ® Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER _ 1 * 1�"®����
FREEDOM OF INFORMATION OFFICER SI"
11
/ 7 77
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: December 11, 1997 •
•
Transmitted herewith is a copy of application No. 1853 for a Cesspool/
Septic Tank Construction Permit submitted by:
John Scaramucci for Nancy Reeve .
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 recd mendations:
APPROVE
DISAPPROVE
Comments:
ignatu
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Dated
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01;3111C1.:? OFI IIE I OWN CLERK ,,� c:)\)[r ULA-T,p .
I own of Southold �J, ,,.;:r. G
Judith I . Terry, Town CI 'gg' e ,►1:: '-1 Application lbo 8- 3
I own hall 53095 Main Road l 1:14:, ��f�``'+r
cn .1t,+,��; I�"y'';A{{ r Construction //
P. O. Box 1179 pl• ly, t!i{.:
Southold, New York 11971 O ' e Alteration
Telephone '�?.' >` :��Of •• Residential
Non Residential
•
I-OWN OF SOUTIIOI_I)
SOur 1101.1) WAS f EWA I ER DISPOSAL I)IS'VIZ IC-r
AI'1'I.IC:A I ION
ho
CONSTRUCTION or AI.'I-NRA-I ION PERMIT
• SEI' I i(; I Al'll< u; CESSPOOL
Permit No.
- DA I F. / 27/tfr 2
APPLICANT NAME: kO)51711 SG z
AI'I'I.ICAN I ADDRESS: ,c * l'103_
SEPTIC SSPOOL -
I)I:SCRII>'rION OF PROPOSED CONSTRLJC-I ION OR ALTERATION /t-2, -,...)
LOCA I ION MAP: Must he attached hereto before permit way be Issued.
I OCA I ION OF PROPOSED) CONS ! RUCT ION OR AI_VERA I ION :
OWNER OF PROPERTY : /1),AAie _ vim
OWNER MAILING ADDRESS: _ /,4 ,L/L
OWNER PROPERTY AI)I)IZESS : nnom�, �/,7Nge141!-
------------..-..C�1 7 _ c G--•---•-----------•_---- -
1 I=I_E1'IIONE NIJMIIER OF CONI AC I PERSON :
I AX MAI' NO. : Section _ /.23 I)Iuc k Cl/ I_ot o /
CROSS STREET : /C-R461-e_.(5 .ad , ..
BUILDING PERMIT NUMBER CROSS REFI.121_NCI: : 4
/
4, 1
J / - Signature of Applicant
RI.CEIVI I) BY : 1 .
�1 1-own Clerk's Offic:e
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SUFFOLK COUNTY DEPARTMENT OP HEALTH SE
I 7 01 PERMIT APPPROVALOF'CONSTRUCTION
/�O� S G T7AMII.Y RESIDENCE ONLY
�' Q # SATE /L � 0.�� "'�7Z
VACANT -
S. W47 40' ' APPROVED
Q'.? FOR MAXIMUM OF BEDROOMS
2O �`` h` , 300 00k EXPIRES THREE YEARS FROM DATE OF APPR
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-' .s:: 288 --- ,4 SURVEY FOR
'e CD
NANCY J.- REEV1
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e6 V AT MATT/TUCK
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�4 - we„ TOWN OF SCUTHO�
SUFFOLK COUNT*Y=-,
•h ALOIS • LANE SO'Eh* = 46
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- - ANY ALTERATION ADDITION TO THRs SURVEY IS A VIOLA now N,• 6 0
- ' OF SECTION 7209 VCCE0T S� THE F EW YGRl�sra mucaT+vw taw .N,1, I�,r; 49 SJR
TION 72O9-StECVY 2.ALL CERTIFICATIONS j /�' N.:
HEREON ARE VALD FAR THIS MAP"AND COPIES OF OILY F
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SAD MAP OR COPES BEAR TIE IMPRESSED THE SURVEYOR
w amu TIRE APPEARS HEREOK M°S" . - - CONIC SURVEYORS,
ADDITIONALLY To COMPLY WITH SAV LAW TEE TERM •ALTERED BY' • 15/61'765 5020
(RAST BE 'TOED ANY AND ALL SUiVEYORS UTILIZING A COPY 17' P. 0.,'BOX 909
FRor r ro-o i ANOTHER EE YDRRT AIA I,r INCE OAS ' C AND
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