HomeMy WebLinkAboutCacioppo / FFO`��
ELIZABETH A.NEVILLE 11��� ® ®.'� Town Hall, 53095 Main Road
TOWN CLERK ® P.O. Box 1179
REGISTRAR OF VITAL STATISTICS � ' Fax(631)� Southold, New York 11971
MARRIAGE OFFICER ` �'®1 r ®�'���
RECORDS MANAGEMENT OFFICER Telephone (63 765-6145
5765-800
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FREEDOM OF INFORMATION OFFICER ����� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2937 R Residential x Non-Residential
Fee $ 10.00 Septic x Cesspool
PERMIT ISSUED TO:
Name : PECONIC CESSPOOL
Address 1: PO BOX 972
City St Zip MATTITUCK NY 11952
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 CACIOPPO, PAUL & MAUREEN
Mailing Address 1 720 NEW SUFFOLK AVENUE
City St Zip NEW SUFFOLK NY 11956
Property Address 1 1265 BAY AVENUE
City St Zip MATTITUCK NY 11952
Tax Map No. section 143.00 block 5 lot 1.000
Cross Street RILEY AVENUE
Building Permit Number Cross Reference:
Issue Date: 12/17/02 Elizabeth A. Neville
Southold Town clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE Town Hall, 53095 Main Road
TOWN CLERK o - P.O. Box 1179
REGISTRAR OF VITAL STATISTICS % �' . 1 Southold, New York 11971
MARRIAGE OFFICER `��,liL �����, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ---- 4q1 jig #00. Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER _ ifs southoldtown.northfork.net
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\: 3 0 20 �'- OFFICE OF THE TOWN CLERK
(\c, `--- TOWN OF SOUTHOLD
TO: '\ :S uthold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: October 30, 2002
Transmitted herewith is a copy of application No. 3056 for a Cesspool/Septic Tank ALTERATION
Permit submitted by:
Peconic Cesspool for Paul & Maureen Cacioppo
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.
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE1 .
DISAPPROVE
Comments: Maintain required setbacks from adjacent wells,buildings,property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED. .
244,..4.g ide.„ -
•
Signature
HA6/0-2.—
Dated
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OFFICE OF THE TOWN CLERK i.
����r�OLkl' 305
TOWN Or SOUTHOLD �� ®/: Application No.
ELIZABETH A.NBVILLE,TOWN CLERK S4&°�
P.O.BOX 1179 . ; Co - - •n �—
SOUTHOLD,NEW YORK 11971 rn Alteration
• �, •
�Q��'�1 $10.00 - Residential ter/
Telephone ':
(631) 765-1800 = ®l' �,00 $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE 10/ 5140°2/
APPLICANT NAME: PECONIC CESSPOOL
APPLICANT ADDRESS: P. 0. BOX 972
MATTITUCK, NEW YORK 11952 '
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: 1`v / etRei, /fir .I.A '
40910411A-5)INER MAILING ADDRESS: 7 �� r '.vim
41„,
Vil411N2
OWNER PROPERTY ADDRESS: / 9. 6, 5 /-j,
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TELEPHONE NUMBER OF CONTACT PERSON: c9,94?-9‘..5e
TAX MAP NO. : Section I91 01) Block 695,-.00 Lot 064, O00
•
GRQSS STREET: X) G Lr
BUILDING PERMIT NUMBER CROSS REFERENCE:
ge6,91-'ate / //
Signature of pplicant
RECEIVED BY: '
Town Clerk's Office
DATE:
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