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HomeMy WebLinkAboutSica, John N ELIZABETH A.NEVILLE ' Town Hall, 53095 Main Road TOWN CLERK .tP.O. Box 1179 I: N Southold, New York 11971 REGISTRAR OF VITAL STATISTICS 15 Fax (516) 765-1823 MARRIAGE OFFICER �o ,l RECORDS MANAGEMENT OFFICER :�ti�f� Telephone (516) 765-1800 � .a FREEDOM OF INFORMATION OFFICER y I , '• OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 1987 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : JOHN T. SICA Address 1 : 1602 CLIFTON STREET City St Zip BALDWIN NY 11510 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 #R10-97-150 Name Of Owner SICA, JOHN T. Mailing Address 1 1602 CLIFTON STREET City St Zip BALDWIN NY 11510 Property Address 1 12860 MAIN ROAD City St Zip EAST MARION NY 11939 Tax Map No. section 31 .00 block 14 lot 9.000 Cross Street Building Permit Number Cross Reference: Issue Date: 1/22/99 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) / oF /0,�oS�FFO(,�CpG- ELIZABETH A.NEVILLE .Z. y�% Town Hall, 53095 Main Road TOWN CLERK = < P.O. Box 1179 ' N = Southold, New York 11971 REGISTRAR OF VITAL STATISTICS1141.3 Fax (516) 765-1823 MARRIAGE OFFICER Z RECORDS MANAGEMENT OFFICER y�ol ��, Telephone (516) 765-1800 �- FREEDOM OF INFORMATION OFFICER - gg g '''sI OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: January 5, 1999 Transmitted herewith is a copy of application No. 2067 for a Cesspool/ Septic Tank Construction Permit submitted by: John T. Sica & Lucia M. Sica 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 Comments: Si ature i /ii / Dated OFFICE OF THE TOWN CLERK ,OCO01/(4;--- lb41 TOWN OF SOUTHOLD �;' %. Application No. F.I.I7ABETH A.NEWT I P,TOWN CLERK ;�► P.O.BOX1179 Construction `/ SOUTHOLD,NEW YORK 11971 i on ; Alteration Telephone 00 �Q`.,' $10.00 - Residential 1. (516) 765-1801 —.1 l' ,,,o $25.00 -Non-Residential _,,,I,, TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT RECEIVED APPLICATION JAN 199) for ao irnond town Clerk CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 0c)Fee $7,Q i DATE ,_ _ / t ' ,-% 79-�, APPLICANT NAME: li"6'ff/f� / , 7e I/6'e_7/T /1 Etc„,17 APPLICANT ADDRESS: / d e.„4/. .-7. )/ii ,-(7--/e6---z--)---- 779Z-2). 46/./li /ii _Y, 17..(7.6' SEPTIC CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION /' A./. --1,61" /Lie /1&---- . 27-- /-28 Z C' / 31,9/, f /Ian //7 S� LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CON--ST--RUCTION OR ALTERATION: �/ OWNER OF PROPERTY: aff40 TS (c°/ OWNER MAILING ADDRESS: /4 o„ t G-/1P 7-0,(J \r/L/(76-7-&---7- 19L1�1-0 iX) /l/e: > 7i K < ( C OWNER PROPERTY ADDRESS: / )- S- 6/0 /1---7,l1 fj.ecce— rE .J TELEPHONE NUMBER OF CONTACT PERSON: .,S /4 -c‘cf-e�o _ -S TAX MAP NO. : Section ` Block /7- Lot e0e7 CROSS STREET: BUILDING PERMIT NUMBER CROSS REFERENCE: 'S__-- -/'- e-e-e< 7,2 ' ...4-'1 _ Signature of Applicant RECEIVED BY: V �'' Town Clerk's Office DATE: I s`cl` 5:c_ tYf`O SANO, LOAM * ge4VEL- j PBt<tMITFOR APPROVALurw1w,au.........•.,.... 1 it �{� i +ANGLE FAMILY RESIDENCE ONLY ,,y \t, 40' WATEe u-J m1YE17 5M+13 Lown * 6¢s•v ),ATESEP 28 EiS ,.to - iso v WATE6 ►u be4WM FINE m Goa¢5z •54wv • APPROVED I w►TN veeY 14&kW 6e6VE Ow) FOR MAXIMISE ol+„}...BEDRo0MS • — i------ DATA FR ?h I DON A/4-0 GE.n 5C,►FNCF I 1HRBEYEARSFROMDATEOFAPPROVAL R` _ OAT 42 11-In-97 Sub ZEcr- TO Ta* M 41,10114110.41- OP ti �� TEST HOLE DATA GtiA ,ac. . lrt.a,:vwst;. ('LA0 s., ,)/o/n/ e0,4o 4a 45-g.-\o-91-0150 . Approved in accordance w Boa • of.:eview determination dot . 12. i yc N Eft c)4'E _ /0.F.0' ----- 4,1 p'—Faop 110 v�rl I • 1_ES7 I zyt _...;r----4..: -fit • , t 44 S o' f j' �v 0. i i1 128' N . ./t j ,1. G.O •, PQOtwE:v SGRADIN• - - less posh.s Z faro % a Gvl.,Tow RS IN Feel Q/ ` '-. \ i 0 (P¢oY/Oe wALL Fc¢. Or20/e.vhv) QCV '''(44)__,..,,, ni 1 0/� i l V Y VI — )( !p 9aP�'CU W , F. I 16E5t0fNGr i 1 it I _to' �TIoN: '91 `y va. 141. n Oy 1__ _ _ .`a- �,i �rs5ilio ix. 1 �. Re i N N \ s.0 .... -- 4""-• H¢.rn .1 taL �1.° i . dz a /i '1'V 10-7 1+- �©* 0.14 t , 0 it.`+ - t �/ ':d• P � • 2T PLA N *CALE: 1''•.710' 1