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ELIZABETH A. NEVILLE ��
1•• .0% Town Hall, 53095 Main Road
TOWN CLERK H P.O. Box 1179
REGISTRAR OF VITAL STATISTICS T Southold, New York 11971
MARRIAGE OFFICER �� y Fax Fax(631) 765 6145
RECORDS MANAGEMENT OFFICER �_ RI Alt #001 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2438 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : PECONIC CESSPOOL
Address 1 : PO BOX 972
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
ADDITION OF OVERFLOW TO EXISTING SYSTEM.
APPLICATION APPROVED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner CASCIOPO
Mailing Address 1 44 WILTON ROAD
City St Zip COLD SPRING HARBOR NY 0000
Property Address 1 720 SECOND STREET
City St Zip NEW SUFFOLK NY 11956
Tax Map No. section 117.00 block 8 lot 13.000
Cross Street
Building Permit Number Cross Reference:
Issue Date: 10/30/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE Town Hall, 53095 Main Road
TOWN CLERK o - P.O. Box 1179
REGISTRAR OF VITAL STATISTICS v' Southold, New York 11971
MARRIAGE OFFICER : Fax���1�, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER '/O! -0,06 Telephone (631) 765 1800
FREEDOM OF INFORMATION OFFICER ‘.a 4.041°
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: October 19, 2000
Transmitted herewith is a copy of application No. 2526 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Paul Casciopo
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 followi recommendation:
APPROVE
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
ignatu e
to IH6O
Date
)FFICE OF THE TOWN CLERK ..'`":.."...,,-
Town of S ,jthotd 0.,.'`c,)\\ rmire* Application No.4,5
Application
Judith T. Terry, Town Clerk „•' `
Town Hail, 53095 Main Road _.—.
P. O. Box 1179 if : Alteration �
Southold, New Y 4 I I.; 11971 qF; `_[ �"
_'' . $1n.00 -- Residential _
( 5i6) 765-1$( ? 1 ,, ' $25.00 - Non-Residential - _.
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCT ION or ALTERAT 14) ' PERMIT
•
SEPTIC TANK or CESc11C,OL
Permit ''`D.
Fee $
DATE 1D / o�
APPLICANT NAME:___P.,L_ ___ _.___ _ . _ . _. _._ ._
, APPLICANT CANT ADDRESS: fede1 97,1_
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR eki__TERATION ____. ---
___A-4._
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSE,. )NSTRU�"TIO`� OR A<_.rERATION .
OWNER '1F PROPERTY : Otiot,./.._ goitol,,C....C...4)-fiet ___
OWNER .`.AILING ADDRESS: 414
-A.440-4‘e ,t-lie .
OWNER PROPERTY ADDRESS: -,,3.--,ge y(T , '' ` '
2stioarit. - -...ot 'art.#6.46.______ - -----"*'%"esfr,-
TELEPHONE NUMBER OF CONTACT PERSON. cio- r. 9G5.r '
TAX MAP NO. : Section1 ri Block d? Lot 13
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERE,A ZE:
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RECEIVED BY:
-roath Mark's Office
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