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JUDITH T.TERRY �/ • ��\� Town Hall,53095 Main Road
TOWN CLERK ;�-;' �-; P.O.Box 1179
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"-� Southold,New York 11971
. REGISTRAR OF VITAL STATISTICS 1 Fax(516)765 1823
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MARRIAGE OFFICER � � �s�°.', ®x/11
RECORDS MANAGEMENT OFFICER ®8 z s' `00' Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER ._� ,,s•'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3296-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner SPARACINO, STEPHEN
Mailing Address 1 P. O. BOX 1300
Mailing Address 2
City St Zip ROCKY POINT NY 11778-0000
Property Address 1 WILLIS CREEK DRIVE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-5797
Tax Map No. section 115.00 block 17 lot 17.0111
Cross Street NEW SUFFOLK AVENUE
Issue Date: 12/20/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
' OFFICE OF THE TOWN CLEiRK-' � ,rl-g�^ �. 3414
Town of Southold
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Judith T. Terry, Town Clerk ,'' •
Application No7
Town �'1
Hall, 53095 Main Road ' ":;5.;!• � Si. �
P. O. Box 1 179 u' t1 ,� . �" n///y�� Construction
Southold, New York 11971 f- r Alteration
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Telephone •01 i SIC* Residential v
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(516) 765- 1301 "�•
Non-Residential
• TOWN .OF SOUTHOLD
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SOUTHOLD WASTEIVATER DISPOSAL. DIST,R.a
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APPLICATION !'y:s • �t°I1, , 2 5 1993
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1PC SC g �4TOWN JF,SOU(ia()'. .
SEPTIC TANK or CESSPOOL
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Permit No.
Fee .$
DATE //'a?6 ' 93
• APPLICANT NAME: ....ST/e4/71/./2 S',0,9 Kw d»
APPLICANT ADDRESS: PQ Box /800
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SEPTIC / CESSPOOL •
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERAT)ON:
OWNER OF PROPERTY:
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OWNER MAILING ADDRESS: I 0 300
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JP / L I // ,)9
- OWNER PROPERTY ADDRESS: 1" S • / '
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TELEPHONE NUMBER .OF CONTACT PERSON: p7Y1 5292
TAX MAP NO. : Section /M Block / 7 /?
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CROSS STREET: ifi .sUcFD/k a,,,,,________T___±________________z_
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BUILDING PERMIT NUMBER CROSS REFERENCE:_.
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°ignaturc .f Applicant
_y„ ,..4,;%,,• RECEIVED BY:
Town Clerk's Office
DATE: RECEIVED •
-DEC 1 4 1994w > .
town Cleric :1; u /
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o Young & Young, Land
.„)..1,___ _._:„ -4 400 Ostrander Avenue, Riverhead,
Vaung DEPARTMENT OF HEALTH SERVICES SUFFOLK COUNTY DEPART %N 516-727-2303
SINGLE FAMILCY DW�FONLY �a
Approval of onstru mc
i�nung ate NOV 01. 1984
H.S.f39f.No. 9 s 0'�c' D Alden W. Young, Professional Engineer
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£ gad
� Howard W. Young, Land Sv
1 ( p. ) The sewage disposal and water sup facilities I O Thomas C. Wolpert, Profeastonat
r at tilts IC:'Btlon have been Inspect and/or IJ " Kenneth F. A6ruzzo, Land S�
' EegI,s nnus certified by this Department or other agencies t ,3 - M
g and found to be satisfactory. 1. :,4:21 N n
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CCJ
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Y S phen A.Costa,P.E..Chief 310•�'
Office of Water end W2stewatRt Ma118 rd ,, ------0..0 c• Pr /'• , - -
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,C In Q 36' 66 J, I Lu 'I AM FAMIUAR WITH THE STANDARDS FOR APPROVAL AND CC
W Xrn..4 _ ‘,,t, P•l�, °p�\ SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES AND
Q _ 'T6 5•� t 25Py01.e°66 5•`; 17-/C.p / , SET FORTH THEREIN AND ONTHE PER IT TO CONSTRUCT'Cr) il `
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Q a o \e\OPi m t\6P�.?6 y46 — p pT ' v 'f SIGNATURE q�1
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S 04205 F‹i' Suffolk County, New York
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1�t 15 �Fy�F • Suff. Co Tax Map:/ ' 1000 I15
District Section
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CERTIFIED TO:
'`�( NE{q/YELAINESTEHENSPARAC SPARACINNO O
P P��D w Y,,��� STG ASSOCIATES, INC
NOTE' 1 T '' �ti� (7
r I ■=MONUMENT FOUND A=STAKE FOUND
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2 SUBDIVISION MAP FILED IN THE OFFICE \‘'s\-),,,,,,,45893,...:
G�OF THE CLERK OF SUFFOLK COUNTY ON � " DA
AUG 21, 19 7 AS FILE NO.8377SF � SC3 FIRM ZONE 44 BASE EL = 8 0 • S JOI
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