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HomeMy WebLinkAboutPisacano 1/, JUDITH T.TERRY Town Hall,53095 Main Road TOWN CLERK g t P.O.Box 1179 REGISTRAR OF VITAL STATISTICS `0 0 • �, Southold,New York 11971 MARRIAGE OFFICER � ®� ,•� Fax(516)765-1823 RECORDS MANAGEMENT OFFICER 424 ,..11� Fax (516)765-1800 FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 1258 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : MICHAEL PISACANO Address 1 : P. O. BOX 40 City St Zip JAMESPORT NY 11947 Descripton of Proposed Construction or Alteration SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING. APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES. SCHD REF. #R10-94-0118 Name Of Owner PISACANO, MICHAEL Mailing Address 1 P. O. BOX 40 City St Zip JAMESPORT NY 11947 Property Address 1 1240 PARADISE SHORES ROAD City St Zip SOUTHOLD NY 11971 Tax Map No. section 80.00 block 1 lot 24.001 Cross Street NORTH BAYVIEW AVENUE Building Permit Number Cross Reference: Issue Date: 12/12/94 Judith T. Terry Southold Town Clerk (TOWN SEAL) UL/f it IA JUDITH T. TERRY . Town Hall, 53095 Main Road TOWN CLERK ;% P.O. Box 1179 U Southold, New York 11971 REGISTRAR OF VITAL STATISTICS ' Fax (516) 765-1823 MARRIAGE OFFICER &X- o'' Telephone (516) 765-1801 RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department ir—DEC7-71gm FROM: Linda J. Cooper, Southold Town Clerk's Office BLDG.DEPT. DATED: December 7, 1994 TOWN OF SOUTHOLD Transmitted herewith is a copy of application No. 1304 for a Cesspool/ Septic Tank Construction Permit 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 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 0111. Comments: JC L - ,o — 9 c-7 /a RECOVED Ay Signature DEC 9 1994 /, Dated Town Clerk Southold yap ; j•.: •-,,',::.1:-'"', ,' '7..1';'.;';',.. 't -:',' ‘',..'•!,' .,:'-: i.E.::,:.;f7ai ';(*JEFAI it....f..,..i i ---- -'.,-;,:-•`,''•,;;;4;,fttrii *-- 1 . ,' „ I. ,' i.f..) .,--171.<!:.'.7:- ,',1 CF .,', : -C lti • . • i ,._. ) , -:1' • '4 (13 i - 1 . 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' HEALTH SERVICES , OFF4rcE OF THE TOWN CLERK ,.,'""'"' Town of Southold .�'� stf o rt,A S Judith, T. Terry, Town Clerk ;'�O co. Application No. ( .7C,7 Town Hall, 53095 Main Road ;$ Construction t P. O. Box 1179 Southold, New York 11971 tl� Alteration Telephone - Q���' $10.00 - Residential (516) 765-1801 _ ��►�! iia �� 't $25.00 -Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee $ DATE 41— 6 - y'K APPLICANT NAME: g 64 eAwe/A/A/O APPLICANT ADDRESS: ?G'-77 es ci /11, //7y7 SEPTIC E TIC CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION S 0/VC --4-01/6"/ P w6-LC/11iG LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: ' OWNER OF PROPERTY: 5AQ-w F OWNER MAILING ADDRESS: OWNER PROPERTY ADDRESS: /2-V 2/9.e"/�2 TELEPHONE NUMBER OF CONTACT PERSON: ?ZZ -cn7S TAX MAP NO. : Section O Block ( Lot Z K CROSS STREET: BUILDING PERMIT NUMBER CROSS REFERENCE: de // Signature of Applicant RECEIVED BY: 4 Town Clerk Office DATE: —