HomeMy WebLinkAboutSantacroce, Kevin 4' O�FFOC C'
ELIZABETH A. NEVILLE Town Hall, 53095 Main Road
TOWN CLERK k c P.O. Box 1179
♦ N Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = rr Fax (516) 765-1823
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER y• Qtr( Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ���� 1, ��)y�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2215 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : KEVIN SANTACROCE
Address 1 : PO BOX 1794
City St Zip SOUTHOLD NY 11971
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. REF #R10-99-0219
Name Of Owner SANTACROCE, KEVIN
Mailing Address 1 PO BOX 1794
City St Zip SOUTHOLD NY 11971
Property Address 1 1000 LAUREL AVENUE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 56.00 block 1 lot 2.029
Cross Street POND AVENUE
Building Permit Number Cross Reference:
Issue Date: 12/28/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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•
• ELIZABETH A.NEVI!J,E $1 hy,; Town Hall, 53095 Main Road
• TOWN CLERK p '� P.O. Box 1179
ti = Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ‘
MARRIAGE OFFICER `.‘11 I” Fax(516) 765-6145
RECORDS MANAGEMENT OFFICER y4 a� l�� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ', 1°
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: December 17, 1999
Transmitted herewith is a copy of application No. 2303 for a Cesspool/
Septic Tank Construction Permit submitted by:
Kevin L. Santacroce
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 r ommendations:
APPROVE
DISAPPROVE
Comments:
ignature
1 .1—/ 11 /41
Dated
•
1111
OFFICE OF THE TOWN CLERK s' '��FF
TOWN OF SOUTHOLD ' Q = Application No.
ELIZABETH A.NEVILLE,TOWN CLERK ,�
P.O.BOX 1179 : Construction
SOUTHOLD,NEW YORK 11971 v T
cf" Alteration
Telephone oj,�,� ��Q���'� $10.00 -Residential 6-7-L.(516) 765-1801 _ 1t ,�' $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 bP.CPA-767z- /9 /999
APPLICANT NAME: /" vin ,Z_ JAnM o-c�
APPLICANT ADDRESS: Pa £px /9941
�e v filo/d At.V //9 7 I
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION .riifk tcimi/y
REsIDencE
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: -1'AceDG�
OWNER MAILING ADDRESS: 1'D c 1R-61•1
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OWNER PROPERTY ADDRESS: / 0C, 0 4_0 )-o e
Vic) ,4I,,o /b, N )/ //1;7/
TELEPHONE NUMBER OF CONTACT PERSON: '746,-- 4359-
TAX MAP NO. : Section 5& Block d/ Lot a. O
CROSS STREET: -L n s4 _----ofr-ep=./ dcb,76 , ,ve
BUILDING PERMIT NUMBER CROSS REFERENCE:
'4/(All
Signatu of pplicant
RECEIVED BY : at-9
own Clerk's Office
DATE: / i/ y 9
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