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HomeMy WebLinkAboutPassalacqua OFFICE OF THE TOWN CLERK c0FO(A'l," Town of Southold ,0� Judith T. Terry, Town Clerk : *: Town Hall, 53095 Main Road , P. O. Box 1179 etf` a • Southold, New York 11971 Oftl) . �• - Telephone l * ,�- (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 148 Residential X Non-Residential Fee $ 10.00 (paid) Septic Cesspool X PERMIT ISSUED TO: NAME: Salvatore Passalacqua ADDRESS: 42 Valley Road Plandome, New York 11030 DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION New Single Family Dwelling LOCATION OF PROPOSED CONSTRUCTION or ALTERATION: , OWNER OF PROPERTY: Salvatore Passalacqua OWNER MAILING ADDRESS: - 42 Valley Road Plandome, New York 11030 t . OWNER PROPERTY ADDRESS : Oregon Road Cutchoque, New York TAX MAP NO. : Section 83 Block 2 Lot pip 4 CROSS STREET: Duck Pond Road BUILDING PERMIT NUMBER CROSS REFERENCE: • Judith T. Terry Southold Town Clerk DATE : April 15, 1987 (TOWN SEAL) , t ,Ala dd4zr- Fes, .i4 LT' >'R> ,' t Town Hall, 53095 Main Road ;P ,y P.O. Box 1179 '...10/ 457, •. Southold, New York 11971 TUDITH T. TERRY ..w,,is+ TELEPHONE TOWN CLERK (516)765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD April 15, 1987 • Salvatore Passalacqua 42 Valley Road Plandome, New York 11030 Re: Oregon Road 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, Judith T. Terry Southold Town Clerk Enclosures (3) JTT/Ijc OFFICE OF THE TOWN CLERK Town of Southold Judith,.T. Terry, Town Clerk Application No. `4.5: - Town Hall, 53095 Main Road Construction Z� P. O. Box 1179 Southold, New York 11971 Alteration Telephone Residential (516) 765-1801 Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. ) `7, Fee $ J � ' DATE APPLICANT NAME: >�L1..,10-L-e_ �c�55a1 � Gq ca�1 APPLICANT ADDRESS: 4Z VaU c ,i [26ac. P Lc,c,40 w.C'_( c b 30 SEPTIC /CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION S�( 5-(_e- rev �eSi E� c� LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: So.(l/a,-corC— (9a,SSc,(c, jc OWNER MAILING ADDRESS: 4-Z q.c,a-e (2-© cc c)( Gam. , if 3v OWNER PROPERTY ADDRESS: D Q6\0fr\ (i U-f-GL\ 0 U e— 1.(.q TELEPHONE NUMBER OF CONTACT PERSON: (0-Z-7 TAX MAP NO. : Section 03-5Block 02, Lot pl O d. CROSS STREET: Q re T„,,, [2_ {),A BUILDING PERMIT NUMBER CROSS REFERENCE: Signature of Appocant RECEIVED BY: aIV Town Clerk's Office DATE: 1887 V 'k SO tioI 1 _ ! ! _r r 0 .- UN 0 cJ. 0 �,�N�AA `9131 e'6 N ISS - 41 N G / ,86.4 L 5 _9,6 r,,tNv1t_____________ 5- ; —i� / 7403, 10" E' ne �1°n1 _�'�����f� s >,..„..::5 rH*101111rf tie ..„:„_____________-_______/.-----_-?..-..-- _ at yi i 6,. /7, �j 22tiDi.„..--;-- (X. ) F /b ' /,yr 1 1 i 0., i '' ,i 1 ,,,,.i./- 1. — � :; 34�-� /// ' 7" /7 17,17 6/ /7/ ' /<°,74y----\V 4)4b /17/_____. , / o � � o a� / br, e Ir Ij a ____IR, va,V i / 0 /%i-t Z - %u.; �° \ ti fL v T.�"sr hole. / C° ti 11 A 0.6 A \l'\' ' . 1 I , „..... \ .- C/ N \ c� �Skt \ O \ \ < .i