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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK ,
® FINP.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
�. .r' Fax (516) 765-1823
MARRIAGE OFFICER Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICERcfj sw d
FREEDOM OF INFORMATION OFFICER �, rlii�Il �/�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1153 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JOSEPH C. SPITALIERE
Address 1 : 9 NOEL PLACE
City St Zip SMITHTOWN NY 11787
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 #92-SO-06
Name Of Owner SPITALIERE, JOSEPH C.
Mailing Address 1 9 NOEL PLACE
City St Zip SMITHTOWN NY 11787
Property Address 1 ROBINSON ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 81 .00 block 1 lot 16.003
Cross Street PARADISE PT. ROAD
Building Permit- Number Cross Reference:
Issue Date: 6/24/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY :' Town Hall, 53095 Main Road
TOWN CLERK ® P.O. Box 1179
6� � Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
i Fax (516) 765-1823
MARRIAGE OFFICER __ 4'`® , .• Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER _ 1 �►.
FREEDOM OF INFORMATION OFFICER '-- ri,��1r1I.
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD D R
TO: Southold Town Building Department lJi`' 2 0 1994 ' if
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: June 17, 1994 T,'r
Transmitted herewith is a copy of application No. 1196 for a Cesspool/
Septic Tank Construction Permit submitted by:
.. - Joseph C. Spitaliere .
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
141)
Comments: *21 . ��„‘,6 ��
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RECEIVED 9 Aeir
JUN 2 4 197794 Signature
A„
a./... y ,
Town Clerk Southold
•
Dated
-
OFFICE OF THE TOWN CLERKcvFFD1A -
Town of Southold 0�0CSG
Judith T. Terry, Town Clerk F.-� ' : Application No. //�j�
Town Hall 53095 Main Road
• carp t- �.��;,; 'µ•. � Construction �
P. O. Box 1179 CO:,:-
Southold, New York ] 197] O'I . $ Alteration
0-`�_ ���. Residential -
Telephone 1t ,
(516) 765-1801 '"
Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE ‘//7 1X
APPLICANT NAME: c.4:j/J S%/ /12/ ej^e
APPLICANT ADDRESS: q , ' (-
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SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: „geslit G ./ ���
OWNER MAILING ADDRESS: q ,t/,eL ,L.
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OWNER PROPERTY ADDRESS: ge.,Z/,vso,v JZ
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TELEPHONE NUMBER OF CONTACT PERSON: 67e 7.29- , Zz 7 C.-16 )
TAX MAP NO./Section ' g Block f Lot /1,2
CROSS STREET: 1 . wasmou o� , dI & 271
,
BUILDING PERMIT NUMBER CROSS REFERENCE:
�. ..a C,r/./ T .� i
�•' S i. atu'e of Applicant
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RECEIVED BY: r L_,___
/To n Clerk's Office
DATE: / Ai - `�
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