HomeMy WebLinkAboutPisacano, Michael 1,I••O��g�FFO��-coG
ELIZABETH A. NEVILLE ��_ yd Town Hall, 53095 Main Road
TOWN CLERK t o P.O. Box 1179
�` Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Q � Fax (631) 765-6145
MARRIAGE OFFICER ,y
RECORDS MANAGEMENT OFFICER _"'/n/ �AN•••' Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER _ �S
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2253 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : MICHAEL PISACANO
Address 1 : PO BOX 1931
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 #R10-99-0233
Name Of Owner PISACANO, MICHAEL
Mailing Address 1 PO BOX 1931
City St Zip SOUTHOLD NY 11971
Property Address 1 SMITH DRIVE SOUTH
City St Zip SOUTHOLD NY 11971
Tax Map No. section 76.00 block 2 lot 22.000
Cross Street MAIN BAYV I EW ROAD
Building Permit Number Cross Reference:
Issue Date: 3/01/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE �� tiz 'a• Town Hall, 53095 Main Road
TOWN CLERK ` C - P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �` Prf
,',� Southold, New York 11971
MARRIAGE OFFICER �L Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER Ly"7�1 �aii� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: February 24, 2000
Transmitted herewith is a copy of application No. 2342 for a Cesspool/
Septic Tank Construction Permit submitted by:
Michael Pisacano
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 applica ion and location map of the project cited above
and make the following re mmendations:
APPROVE
DISAPPROVE
Comments:
ignatup..(.3.4/6r
Dated
F
OFFICE OF THE TOWN CLERK ,�' cC
TOWN OF SOUTHOLD �'� �"�FO `O Application No.r c/k_
F1.17ABETH A.NEVILLE,TOWN CLERK
P.O.BOX 1179 Construction
SOUTHOLD,NEW YORK 11971 0 r=11
Alteration
Telephone 0,� Q�i�, $10.00 - Residential A —
(516) 765-1801 ' h0l 1114 ,e $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
APPLICANT NAME: 1A�� 6
APPLICANT ADDRESS: O G r. t 93 )
`( l
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY:
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS: 5 r ],' X -w"
TELEPHONE NUMBER OF CONTACT PERSON: ,2OP- 3Y7
TAX MAP NO. : Section 7b Block Lot 2
CROSS STREET:, p (tf rf%A op
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY :
Town � /C,lerk's Office
DATE: `�Ic,5//C)CJ
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