HomeMy WebLinkAboutPisacano OFFICE OF THE TOWN CLERKFO(A'`,O"
Town of Southold
Judith T. Terry, Town Clerk Z = �
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Town Hall, 53095 Main Road
P. O. Box 1179 .v' , 2
Southold, New York 11971 O '"fi " •
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(516) 765-1801 ' -
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 214 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool X
PERMIT ISSUED TO:
NAME: Michael Pisacano
ADDRESS: Box 561, Main Road
Jamesport, New York 11947
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling with Sanitary System
Approved as per Suffolk County Health Department approval
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF- PROPERTY: :Michael and Lauren Pisacano
OWNER MAILING ADDRESS: Box 561
Jamesport, New York 11947
OWNER PROPERTY ADDRESS : 945 Victoria Drive
Southold, New York 11971
TAX MAP NO. : Section 78 Block 9 Lot 57
CROSS STREET: Liberty Lane
BUILDING PERMIT NUMBER CROSS REFERENCE.
Judith T. Terry
Southold Town Clerk
DATE : August 18, 1987
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DL `' `'� ��� Town Hall, 53095 Main Road
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4 e ? Town Hall, 53095 Main Road
P.O. Box 728
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JUDITH T.TERRY TELEPHONE
TOWN CLFRI:
(516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
August 18, 1987
To: Victor Lessard, Southold Town Building Department
From: Judith T. Terry, Southold Town Clerk -
Transmitted herewith is a copy of application No. 217 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by Michael Pisacano
Please review the application and location map and advise if the
project has received Suffolk County Health Department approval
and if we may issue the permit.
Please complete the form below and return it to my office.
Thank you.
Judith T. Terry
Southold Town Clerk
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I have reviewed the application and location map of the project
cited above and make the following recommendation:
APPROVE -
DISAPPROVE -
COMMENTS: C�
Signature
11
Date
OFFICE OF THE TOWN CLERK c0FU1 7
Town of Southoldf C� - Application No. �f
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road vat k Construction / _
tr1P. O Box 1179cyt;' , '"CJ
Alteration
Southold, New York 11971 ® ��-9,
Telephone
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�� Residential i
p
(516) 765-1801 "' Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. e('(
Fee $ /C)
DATE fry /P /f/7
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APPLICANT NAME: /tc/4i / 401e/1-4/6
APPLICANT ADDRESS: dciy S '/ /724-€.14/ 4C,q, pril ffigCar �� 1/5'(/7
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: rn L hpc-r 1 + Lv\-v►a^ein1
OWNER MAILING ADDRESS: T.cY S`(o ( TKvv,es PcPse `i a
OWNER PROPERTY ADDRESS: (J \N 'C"e '(c brty-c
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TELEPHONE NUMBER OF CONTACT PERSON: 702,9 _ 8/rir
TAX MAP NO. : Section 77f Block 2 Lot -S-7
CROSS STREET: ('( f (44`'`c
BUILDING PERMIT NUMBER CROSS REFERENCE:
.1/AC44(//lee'e:
Signature of Applicant
RECEIVED BY . _-
own 62"lerk's Off4ce
DATE: - /J J 7
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GREENPORT NEW YORK
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