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p Town Hall, 53095 Main Road
� ��� P.O. Box 1179
-- �o of Southold, New York 11971
JUDITH T.TERRY =1„ ����, 765-1823
TELEPHONE(516)765-1801
TOWN CLERK
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. 526 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : RICHARD MAGILL
Address 1 : PECONIC CESSPOOL
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
ADDITION OF NEW OVERFLOW CESSPOOL TO EXISTING SYSTEM.
APPROVED AS SUBMITTED. NOTE: EXCAVATION INSPECTION REQUIRED.
Name Of Owner GIACOMO, CICCONE
Mailing Address 1 IANNOLO, SAL
141 WESTBURY AVENUE
City St Zip MINEOLA NY 11501
Property Address 1 1215 BAY AVENUE
City St Zip MATTITUCK NY 11952
Tax Map No. section 143.00 block 5 lot 7.002
Cross Street RILEY STREET
Building Permit Number Cross Reference:
440.Wtarratf,"'
Issue Date: 8/09/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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BLDG.DEPT. r J p �,�`, Town Hall, 53095 Main Road
TOWN OF SOUTHOLD _ 4e, ����•' P.O. Box 1179
_"rig ••0° Southold, New York 11971
JUDITH T. TERRY -•"-F. "o', TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
August 4, 1989
To: Victor Lessard, Southold Town Building Department
From: Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. A539 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Ciccone Giacomo
Please review the application and location map and advise if this office may
issue the permit.
Please complete the form below and return it to this office.
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Thank you.
6,44,X.41-4(...
Linda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE - D(
DISAPPROVE - /)
COMMENTS: 0,...„ .w..c,Qil cZ_e.S_ r..1 4d2..all £ 7 Q
NV -
RECEnoto
at, CIE
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AUG 071989 Signature
*Wieldromp Nit Date )3\, 1
OFFICE OF "FNFIE TOWN CLERK S�FFULA
Town of Southold � C`�/y , Application No. /I-53Y
Judith T. Terry, own Clerk
Ierk
Town Hall, 53095 Main Road Construction
P. 0. Box 1179Alteration
�.
Southold, New York 11971 t � Residential
Telephone
(516) 765-1801 "' Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCT ION or ALTERAT ION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE 8///0 /7
APPLICANT NAME: /L49J
APPLICANT ADDRESS: /? o E Cidiry Is--
SEPTIC
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: /6, G v,vey- �cevor
OWNER MAILING ADDRESS: J -�_ , ,q-^/A/p,
/54/ h✓03c76 ' /01"--
OWNER
g'OWNER PROPERTY ADDRESS: ,7✓14o//r
/2-t5
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TELEPHONE NUMBER OF CONTACT PERSON:
?mac
TAX MAP NO. : Section /93 Block S Lot 7. O O 2-
CROSS STREET: AffL
BUILDING PERMIT NUMBER CROSS REF
ERENCE:
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RECEIVED Signature of Applican
RECEIVED BY: AUG 04 1!
Town Clerk's Office
DATE: Town Clerk Southold
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