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ELIZABETH A.NEVILLE /�� ';�'4ti z To:A; Town Hall, 53095 Main Road
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TOWN CLERK
P.O. Box 1179
REGISTRAR OF VITAL STATISTICS -4' A w � Southold, New York 11971
MARRIAGE OFFICER `'- ��,1� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ®� 14® � Fax
(631) 765-1800
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK '
SOUTHOLD ' T 4$(EBBTW$IE'IOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2611 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL
Address 1 : 2760 YENNECOTT
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
ADDITION TO EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner PISACANO, GASPER & ADELINE
Mailing Address 1 MAIN ROAD
City St Zip JAMESPORT NY 11947
Property Address 1 16155 ROUTE 48
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 101 .00 block 1 lot 15.001
Cross Street
Building Permit Number Cross Reference:
Issue Date: 7/24/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE �' Y Town Hall, 53095 Main Road
TOWN CLERK k x - % P.O. Box 1179
REGISTRAR OF VITAL STATISTICS 0' �' 0 Southold, New York 11971
MARRIAGE OFFICER *.s..#4,® `' `®�,i1 Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER __ ®d toll Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ..I,i
OFFICE OF THE TOWN CLERK -
SOUTHOLD NANSIMENASUEIRTBILSODSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2611 R Residential X Non-Residential
Fee $ 10.00 Septic 1' Cesspool—__>
PERMIT ISSUED TO: ' )r--
Name : MORRIS CESSPOOL on --)
Address 1 : 2760 YENNECOTT rN)CS2`
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
ADDITION TO EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner PISACANO, GASPER & ADELINE
Mailing Address 1 MAIN ROAD
City St Zip JAMESPORT NY 11947
Property Address 1 1615 ROUTE 48 .1-rt 16'QS
co 2P.�ec�'
City St Zip MATTITUC NY1195 040h-Ca2A-Q.._
Tax Map No. section 1 i . 4 1 block ---1 It 15.001
II 1 lq3�
Cross Street
Building Permit Number Cross Reference:
Issue Date: 7/24/01 "izabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
oFFOLafr
ELIZABETH A.NEVILLE /At =`°a � Town Hall, 53095 Main Road
T0WNall, 5% p" ;:°k; P.O. Box 1179
•REGISTRAR OF VITAL STATISTICS • tt' ` �',- 4E Southold, New York 11971
MARRIAGE OFFICER �� �[� 1 /, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER Ye/ Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER `zs'
......,i
OFFICE OF THE TOWN CLERK
SOUTHOLD TIOWNEWASREIEtTBEISINDSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2611 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL
Address 1 : 2760 YENNECOTT
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
ADDITION TO EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES.
EXCAVATION INSPECTION REQUIRED.
Name Of Owner PISACANO, GASPER & ADELINE
Mailing Address 1 MAIN ROAD
City St Zip JAMESPORT NY 11947
Property Address 1 16155 ROUTE 48
City St Zip MATTITUCK NY 11952
Tax Map No. section 101 .00 block 1 lot 15.001
Cross Street
Building Permit Number Cross Reference:
Issue Date: 7/24/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
ti
ei OFFOiAr a (0 (
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• ELIZABETH A.NEVILLE �0 '�A Town Hall, 53095 Main Road
TOWN CLERK ; CO, P.O. Box 1179
REGISTRAR OF VITAL STATISTICS 0 �� Southold, New York 11971
MARRIAGE OFFICER .fi ����� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER �__�01 10�'ii Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ���
•
OFFICE OF THE TOWN CLERK •
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED; June 11, 2001
Transmitted herewith is a copy of application No. 2691-A'for a Cesspool/Septic Tank ALTERATION
Permit submitted by:
Morris for Stephen Pisacano
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.
Siinature
Ihjo
Dated
, ',.
OFFICE OF THE TOWN CLERK ;, c�VF�OL
TOWN OF SOUTHOLD ��` QG _ Application No.Q '9'/
.4
ET VABETH A.NEVILLE,TOWN CLERK 0
P.O.BOX 1179 Construction (� _
SOUTHOLD,NEW YORK 11971 v T
• i fit
t, e
; $10.00 -Residential
Telephone 440(631) 765 1800 - 1 � $25.00 -Non-Residential
,..,,:.
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee '$
DATE
APPLICANT NAME: 2ôi4',e1s • /
APPLICANT ADDRESS: 2‘d /17;
SEPTIC CESSPOOL
DESCRIPTION • F, PROPOSED CONSTRUCTION OR ALTERATION
I
•
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTI • N OR ALTERATION: )36-13a)". 01.e&L„,,,,,
OWNER OF PROPERTY: ✓� �
OWNER MAILING ADDRESS: XT T1 C
OWNER PROPERTY ADDRESS: ui 6s ` +c (
TELEPHONE NUMBER OF CONTACT PERSON: YIC )to)
TAX MAP NO. : Section /6 / Block / Lot b., I
•
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
2,„74 . .
Signature of Applicant
RECEIVED BY:
Tow Clerk's Office
DATE: 7//- ��
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