HomeMy WebLinkAboutLoCascio, Antoinette •
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JUDITH T. TERRY �� 1 L Town Hall, 53095 Main Road
TOWN CLERK ` ►� P.O. Box 1179
REGISTRAR OF VITAL STATISTICS T i Southold, New York 11971
MARRIAGE OFFICER �� Fax (516) 765-1823
�Q Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 721 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : ROBERT H. WHELAN, P.E.
Address 1 : P. O. BOX 590
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH SANITARY SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 9/24190.
Name Of Owner LOCASCIO, ANTOINETTE
Mailing Address 1 20 TUTS LANE
City St Zip JAMESPORT NY 11947
Property Address 1 KIMBERLY LANE
(LOT I I )
City St Zip SOUTHOLD NY 11971
Tax Map No. section 70.00 block 13 lot 20.011
Cross Street ROXANNE ROAD
Building Permit Number Cross Reference:
Issue Date: 6/06/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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' Town Hall, 53095 Main Road
• 3 >' " P.O. Box 1 179
1 • Southold, New York 11971
JUDITH T.TERRY yam- TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR Of VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Southold Town Code Enforcement Officer
From: Linda Cooper, Southold Town Clerk's Office
Dated: May 22, 1991
Transmitted herewith is a copy of application No. 739 for a Cesspool/
Septic Tank Construction Permit submitted by:
Robert H. Whelan for Antoinette Locascio
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
DISAPPROVE ae n •
Comments: Q.., ,c..1 al..- d Irv) 0..�t Gt a CXa eQ.
• CA)_ sitz. try\
1-
cilwA9D
410.
Signature
NV S4 JC?
Dated
OFFICE OF THE TOWN CLERK ,,,,�fOl
Town of Southold ,;'O.
�� K`'�l/ Application No. 7:
Judith T. Terry, Town Clerk ;
Town Hall, 53095 Main Road Construction
P. O. Box 1179 ; o rn Alteration
Southold, New York 11971 w;
Telephone =y0,y40 ��4..• $10.00 -Residential t/
(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. ting-
Fee $ /Q
DATE
APPLICANT NAME: 7. €r/G)/& 1 j PG,
APPLICANT ADDRESS: 0 ��� 0 � C,;�,�dw ,4 / i C
SEPTIC v CESSPOOL v
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
,c M) 5,i7Vl7-401/ ,9/S:ririt
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: , ,/,7 2///1,rrhs 4 ed<eiP
OWNER MAILING ADDRESS: Z.0 ,7�5 /00101e[
sensi6cf,er, X17
OWNER PROPERTY ADDRESS: JOT L, 0C,"/ /A145"
5cu17/62, /1)
TELEPHONE NUMBER OF CONTACT PERSON: 2fr
TAX MAP NO. : Section /AV Block 70 "/.3 Lot 00. 1
CROSS STREET: 4 O �E? t/
BUILDING PERMIT NUMBER CROSS REFERENCE:
/Or/ /
AO A
ignatu e of Applicant
RECEIVED BY: gt
Town Clerk's 0 •ce
DATE: /J^/ oZ 6,7//9 /
war
AREA=46,672s Prepared in accordance with /he minimum
NOTE, LOT NUMBERS REFER TO 'MAP OF PARADISE BY THE BAY'
4Yt•`` `. standards /or Nlle surveys as established
FILED NOV. 4, 1976 FILE NO. 6463 AT THE OFFICE OF THE
by the L.I.A.L.S. and approved and adopted SUFFOLK COUNTY CLERK. J43�31tii'/_.,7_,---
Ni....
/,��
(�� for such use by The New York Slate Land i' -_ •
r
\ %% /�� Title Association.
• �l+ The water supply and sewage disposal BIFFOLK cOIMtY DEPARTMENT OF HEALTH SERVICES
�7 °
gine- The
/or this residence will eon/arm
r Q\6 fl O, ` . to the standards of The Sr/folk County FOR APFROVM.CFOpN$TRICTpNpaT
E O M Deportment of Health Services.
�!(/ ("4'• ! DATESEP 24 "+Kg i� D-/i/
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APPROV® Kra i
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'Q The locations of wells and cessp•ols sho n hereon are from field
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s • observations and or from dole obbdin.d Ir in others.
`C' O O� r
/ 7s• 4. SINGLE FAMILY DWELLING O !I.V
tAM1M14$// \/*- g (VACANT)S;;FIY�tS IWO YEARS FROM DA j rpt. p rr• ,,,el
'o SURVEY OF
�` �� �o PROPER TY
lo\ I A T SOUTHOLK
A. �+ sea+� s`� TOWN OF SOUTH
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ali.. ,,. 3 •'. ,a, W 4, ,. SUFFOLK COUNTY, N. Y.
�,.p ,,,e ) I { 1000 - 70 - 13 - 20.11
s \ \ \ s � a o \�,,yo Scale 1" = 40'
sr� � Nov. 7, 1988
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2a / �° \ Aug. 21, 1990(b.o.h.)
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VACANT 9,0
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l '4 // 619 PLEASE NOTE a��� �\
\� blot 0 /; - b4 Sanitary system is not to be
f placed under driveway area.
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