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t 2 Town Hall, 53095 Main Road
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JUDITH T.TERRY --.~10/". TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 384 R Residential X Non-Residential
Fee $ 10. 00 Septic Cesspool X
PERMIT ISSUED TO:
Name : POLICANO, JOSEPH
Address 1: 90 STRATFOR ROAD
City St Zip WEST HEMPSTEAD NY 11552
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY HEALTH
DEPARTMENT 5/23/88.
Name Of Owner POLICANO, JOSEPH
Mailing Address 1 90 STRATFORD ROAD
City St Zip WEST HEMPSTEAD NY 11552
Property Address 1 INLET VIEW EAST
City St Zip MATTITUCK NY 11952
Tax Map No. section 100.00 block 3 lot 10.013
Cross Street HARBORVIEW ROAD
Building Permit Number Cross Reference:
Issue Date: 8/22/88 . Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH
Southold, New York 11971
JUDITH T.TERRY "� `-- '�
TOWN CLERK ~""000,0����' TELEPHONE
REGISTRAR 01-VITAL STATISTICS (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Victor Lessard, Southold Town Building Department
From: Linda Cooper, Southold Town Clerk's Office
Dated: August 10, 1988
Transmitted herewith is a copy of application No. 390 for a Cesspool/
Septic Tank Construction Permit submitted by:
Joseph Policano
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.
.
I , •
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE y,
DISAPPROVE
Comments: C1,3 _A•.�.At.c. sem, • % . • 0. -..1 2,144-4A44--ii 4 ckfr.41.4
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Signature
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Dated
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OFFICE OF THE TOWN CLERK c0FULk1
l/
Town of Southold
Judith T. Terry, Town Clerkr= Application No. 390
Town Hall, 53095 Main Road o t
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22 24 2'6 28 30 32 34 36/LOT 12 40 4z a9 as'`�6 s_ sz _`I - - " MAP OF INLET EAST ESTATES rl
. 38 FILED MAY I, 1975 FILE NO 6249
AREA = I. 106 AC. ` °WE"'"°'
EXCAVATION �SPEC�IOrr REQUIRED AT MATTITUCK
• TOWN OF S0UTHOLD
SUFFOLK COUNTY C'pARTAiENT OF HEALTH SERVICES The water supply n sowoflo conform
disposal sthe
toms for Ihis residence will conform to the
Prepared in accordance with Lha minimumSUFFOLK COUNTY,N. Y.
standards for title surveys as established by FGR A^P:<OVAL CF CONSTRUCTION ONLY standards ea the Services. County Depart- - - -ment of Health Serviclos. 1 00 O 1 OO 0 310 13
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�v LAND ss?./ the L L A L S. and approved and adopta� J��i77 SSii •EF. NO 1 + � �(] - I 1 �7 (� SCALE I " = 40'
-..,•s /g to A En, '9 for such use by The New York State Land DAT-c
Gk05�V h° CSC�,G Title Association.
/ Z ,,lh,a o APPROVED J � �� C�6) SEPT 25, 1987
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=,'_':� S LIC NO 49668 _
J L r'Ii,ir- i- •'+,; ";r -'l,el.I-el. ;�rILV
;PECO A›, '404�(EYe j a' ENGINEERS , P C EXPIRES Ilt\RJ ILA.r .. i :,Ui',1 bAii:. (moi` APPROVAL
( 5 16) •6OR '+•.,• TIE LOCATION OF WELTS AND rESSPOOLS SHOWN HEREON ARE BOM FIELD
P 0 BOX Si: ORSE,.a nays run OH SHOW DATA nRIAINEI IRMA9filE RS
MAIN ROAD
SOUTHOLD , N Y 11971 /a-2o-67 .S °' //-V dMe 4L 7 ELEVATIONS ARE REFERENCED TO MEAN SEA LEVEL