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OFFICE OF THE TOWN CLERK cOFfl/A-c
Town of Southold
Judith T. Terry, Town Clerk ` `-`'."
� 1 � �'' A .G
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 11971O''�f �O�-�,,'
Telephone _ �l [ if
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 60 Residential XX
Non-Residential
Fee $ 10.00
Septic Cesspool XX
PERMIT ISSUED TO:
NAME: Lynch Homes, Inc.
ADDRESS: 321 County Road 39A
Southampton, New York 11968
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION •
New Single Family Dwelling
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
•
OWNER OF PROPERTY: Giuseppe Racanelli
OWNER MAILING ADDRESS: 149-40 22nd Avenue
Whitestone, New York 11357
OWNER PROPERTY ADDRESS : Birch Lane
Cutchoque, New York
TAX MAP NO. : Section 83 Block 1 Lot 22
CROSS STREET: Duck Pond Lane
BUILDING PERMIT NUMBER CROSS REFERENCE: Pending
Judith T. Terry/
Southold Town Clerk
DATE: October 15, 1986
(TOWN SEAL)
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. , ' .'Yr-''` ��+t94 P.O. Box 1179
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JUDITH T TERRY 'l•m 01-- TELEPHONE
TOWN CLI Rh
(516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
October 15, 1986
Lynch Homes Inc.
321 County Road 39A
Southampton, New York 11968
Re: Giuseppe Racanelli
- Birch Lane
Cutchogue, New York
Enclosed herewith is the Construction, Alteration or Modification
Permit for a Septic Tank or Cesspool System for which you applied.
Please be advised that each owner of real property operating an
on-site sewage disposal system, such as a septic tank or cesspool must,
prior to such operation, possess in the name of the owner an Operation
Permit for the system. The Operation Permit is issued by the Town
Clerk's Office.
The fee for an Operation Permit is ten dollars ($10.00) for
residential use and twenty-five dollars ($25.00) for non-residential.
Please have the owner complete the enclosed Application for an Operation
Permit and return it to this office along with the proper fee.
For your general information I have enclosed an Informational
Bulletin regarding the Scavenger Waste Laws adopted by the Southold
Town Board. Should you have any questions pertaining to either permits
or the Scavenger Waste Laws, please do not hesitate to contact this
office. We will be glad to assist you in any way possible.
Very truly yours,
gogge4re„.......:,......#
,....e. 16-Adative....
Judith T. Terry
Southold Town Clerk
Enclosures (3)
JTT/Ijc
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OFFICE OF THE TOWN CLERK
Town of Southold
Judith. T. Terry, Town Clerk Application No. /
Town Hall, 53095 Main Road Construction
P. O. Box 1179 Alteration
Southold, New York 11971
Telephone • Residential
(516) 765-1801 Non-Residential
RECEWFD
TOWN OF SOUTHOLD
OCT 071986
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
Town Cterlt Southold
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 60
Fee .$
DATE OC d6. 7 )q
APPLICANT NAME: &Y/✓GVr /47)111 --1.
APPLICANT ADDRESS: 3.9?/ Uoviv711 R9. 3`71, Yotrl-ii iron /I/1, 1/W
SEPTIC X CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
j cram a_.: /j..a
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: G
OWNER MAILING ADDRESS: ike9' (o c a '°/,/C_, (/ 17�s r✓E i y2
OWNER PROPERTY ADDRESS: //JJ '� //��° �
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TELEPHONE NUMBER OF CONTACT PERSON: OZY3- O DU 7
TAX MAP NO. : Section -147 r"fre'Block -r4-, / Lot 7iZ
CROSS STREET: Z qc' /O,0i/q,v E_
BUILDING PERMIT NUMBER CROSS REFERENCE: � � L
.r
r70)/t- �Ztvi '
Signature of Applicant
RECEIVED BY:
Town C
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