HomeMy WebLinkAboutGambino, Anthony •
OFFICE OF THE TOWN CLERK c��FFO(/-`,
Town of Southold DSO OG
Judith T. Terry, Town Clerk Z .04'
Town Hall, 53095 Main Road
P. O. Box 1179 ..
Southold, New York 11971 c Off.
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Telephone A *
(516) 765--1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 212_ Residential X
Fee $ 10.00 Non-Residential
Septic Cesspool x
PERMIT ISSUED TO:
NAME: Anthony and Grace Gambino
ADDRESS: 85G Deep Hole Drive
Mattituck, New York 11952
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling with Sanitary System
APPROVED as per Suffolk County Health Dept. approval
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Anthony and Grace Gambino
OWNER MAILING ADDRESS: 85G Deep Hole Drive
Mattituck, New York 11952
OWNER PROPERTY ADDRESS : Lupton Point ROW
Mattituck, New York
TAX MAP NO. : Section 115 Block 11 Lot 10
CROSS STREET: Lupton Point
BUILDING PERMIT NUMBER CROSS REFERENCE:
Judith T. Terry
Southold Town Clerk
DATE: August 12, 1987
(TOWN SEAL)
•17.! Town Hall, 53095 Main Road
-..1 -16' ',
P.O. Box 728
,• • Southoid, New York 11971
1•....
JUDITH T.TERRY TELEPHONE
Town CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
August 11, 1987
To: Victor Lessard, Southold Town Building Department
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy of application No. 215 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by Anthony and Grace Gambino •
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.
eg •
gee.
Judith T. Terry
Southold Town Clerk
I have reviewed the application and location map of the project
cited above and make the following recommendation:
APPROVE -
DISAPPROVE -
COMMENTS: Q,V Q'j , ItSLa�
mac. S•-3-irs alL
Signature
ii/th
Date
OFFICE O`F THE TOWN CLERK c�VFFUL4
Judith T. Terry, T wn Clerk Application No.g7/
Town of �O CDy S
Y,
Town Hall, 53095 Main Road cr3j Construction -�
P. O. Box 1179
Southold, New York 11971 Alteration
O( b ;$ Residential
Telephone
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ /0
DATE 6cw . i t 1 cbR
APPLICANT NAME: A00-11401j ? CrzeICE crAG4(3
APPLICANT ADDRESS: , ] (-bL,(3-
SEPTIC XC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
Ww esti•) LLE
LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Art_r-14013 c.7.3-1244167_ cnKl-(.G ,.,1Q
OWNER MAILING ADDRESS: S ( , t L c( O
OWNER PROPERTY ADDRESS: ,� /Iie ,e0(, )
TELEPHONE NUMBER OF CONTACT PERSON: (2,: 9j -- o
TAX MAP NO. : Section lc Block I I Lot F�
CROSS STREET: LL11010 /. -r OCA
C
BUILDING PERMIT NUMBER CROSS REFERENCE:
7j2e/
7ature of Applicant
RECEIVEEg al
own lerk' Office
DATE: AUG11 1987
Town Clerk Southold
- FOLK CO. HEALTH-DE
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PLEASE
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GREENPORT NEW YORK .