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ELIZABETH A.NEVILLE /_ y�: Town Hall, 53095 Main Road
TOWN CLERK ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER � 11 Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER =__'Oi jilig `-.011 Telephone (631) 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. 2508 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JOSEPH T. BARTOLOTTO, II
Address 1 : PO BOX 1274
City St Zip ROCKY POINT NY 11778
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF # R10-00-0284
Name Of Owner TSONTOS, EMANUEL
Mailing Address 1 26 I U WILLETS ROAD WEST
City St Zip ROSLYN NY 11576
Property Address 1 1065 MILL ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 106.00 block 9 lot 10.001
Cross Street JACKSON LANDING ROAD
Building Permit Number Cross Reference:
Issue Date: 2/06/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILFL 2001' to Town Hall, 53095 Main Road
TOWN CLERK ; y - P.O. Box 1179
REGISTRAR,OF VITAL STTISTIC �9`:==�` ; Southold, New York 11971
MARRIAGE OFFICER- -1Si- • Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER �_40 �•���� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER
�i
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: February 1, 2001
Transmitted herewith is a copy of application No. 2596 for a Cesspool/Septic Tank
CONSTRUCTION/ALTERATION Permit submitted by:
Joseph and Pasquina Bartolotto
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.
Linda J. Cooper
* * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments: Maintain required setbacks from adjacent wells,buildings, property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED.
2ture
46. 1o1.
Dated
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OFFICE OF THE TOWN CLERK t.,,, Of vn
TON OF 41 U` CSI GQG
W =•
: Application No. .2..6-9 )/
ELIZABETH A.NEVILLE,TOWN CLERK O
P.O.BOX 1179 • ' i ;" iG
Construction x
SOUTHOLD,NEW YORK 11971 �G
_ ` � � Alteration
Telephone ‘�4 ' Q ;� $10.00 - Residential - x
(516) 765-1801 is' $25.00 - Non-Residential
•
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. - ,_ .
Fee $ 10 .00'
DATE
APPLICANT NAME: Joseph T. Bartolotto II and Pasquina Bartolotto
APPLICANT ADDRESS:c Box 1274
Rocky Point, NY 11778 •
SEPTIC CESSPOOL x- - --- 1 .
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
New single-family dwelling
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Emanuel Tsontos
OWNER MAILING ADDRESS: / Roslyn,WNYlets
576' West
OWNER PROPERTY ADDRESS: 1065 Mill Road
Mattituck, NY 11952
TELEPHONE NUMBER OF CONTACT PERSON:
744-3255
TAX MAP NO. : Section 106 Block 9 Lot 10 . 1
CROSS STREET: Opposite Jackson Landing Road
BUILDING PERMIT! NUMBER CROSS REFERENCE:
• '40 (
SSnatur of Applicant
Joseph ;P/. Bartolotto
RECEIVED BY: L, V -
Town Clerk's Office
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HEALTH Jil t po?..1 COUNTY DEPARTMENT
MENT OF SERVICES
PERMIT FOR APPROVAL OF CONSTRUCTION FOR A
,/ SINGLE FAMILY RESIDENCE ONLY
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