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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK = i P.O. Box 1179
REGISTRAR OF VITAL STATISTICS : v i Southold, New York 11971
MARRIAGE OFFICER g',`� Fax (516) 765-1823
®�, s r s Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 724 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : JOHN SCARAMUCCI
Address 1 : P. O. BOX 1403
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 5/13/91 .
Name Of Owner MILLER, IRENE
Mailing Address 1 3809 211 STREET
City St Zip BAYSIDE NY 0000
Property Address 1 LAKE VIEW AVENUE
City St Zip PECONIC NY 11958
Tax Map No. section 68.00 block 3 lot 10.000,
Cross Street HUNTINGTON BLVD.
Building Permit Number Cross Reference:
Issue Date: 6/06/91 Judith T. µTer ' -
Southold Town Clerk
(TOWN SEAL)
•
' (-ill
24 i992i _
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OIo2�, ' Town Hall, 53095 Main Road
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BLDG. v....0 .. � • +' P.O. Box 1179
.Jnr "� J Southold, New York 11971
JUDITH T.TERRY ' . ; r
TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Southold Town Code Enforcement Officer
From: Linda Cooper, Southold Town Clerk's Office
Dated: May 24, 1991
Transmitted herewith is a copy of application No. 742 for a Cesspool/
Septic Tank Construction Permit submitted by:
John Scaramucci for Irene Miller
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
qt.)1-111;s4ell
Comments: Q.o yam, , , try) 0. 'w0•
c 5 p
S'11\00
A6:6.-bat.
Signature
SiSwict
Dated
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