HomeMy WebLinkAboutAvondet. Charles �egFO��-c
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JUDITH T.TERRY 'f1 1 Town Hall, 53095 Main Road
TOWN CLERK ; N P.O. Box 1179
,� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS 4 11 Fax (516) 765-1823
MARRIAGE OFFICER y 1
RECORDS MANAGEMENT OFFICER = 0.( 1►A 111 Telephone(516) 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. 1632 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : EAST ISLE CUSTOM BUILDERS INC.
Address 1 : 278 JAMAICA AVENUE
City St Zip MEDFORD NY 11763
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.
Name Of Owner AVONDET, CHARLES AND DEBORAH
Mailing Address 1 24 BERGER STREET
City St Zip RONKONKOMA NY 11779
Property Address 1 3755 GRAND AVENUE
City St Zip MATTITUCK NY 11952
Tax Map No. section 107.00 block 1 lot 5.002
Cross Street GRETON COURT
Building Permit Number Cross Reference:
Issue Date: 4/22/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY �t ��0 y� Town Hall, 53096 Main Wad
TOWN CLERK y .C/ Z E.A.•Box 110
T sou thal4;`0044hp71
REGISTRAR OF VITAL STATISTICS .......1.
O4.. Fax(516) 'ib -183
MARRIAGE OFFICER �.��� Telephone (516) 766-1800
RECORDS MANAGEMENTsou th(lig
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK / 3 1
TOWN OF SOUTHOLD G
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: February 21 , 1997
Transmitted herewith is a copy of application No. 1672 for a Cesspool/
Septic Tank Construction Permit submitted by:
East Isle Custom Builders for Avondet •
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.
Thank you.
bS-4-'7t--4-'
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
.
APPROVE •
DISAPPROVE
Comments:
,,
RECEIVED �'` •
/„..i,
Signa•fure
APR 2 M 1997 e//(V, 7
Dated
Southold Town Clerk
A
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OFFICE OF THE TOWN CLERK �c�VFFOL''- r
Town of Southold 1 �Q C'Q1,:•...-t .
'\ Application No./ 6 7)-----
Judith
�
Judith T. Terry, Town Clerk y .
Town Hall, 53095 Main Road a $10.00 - Residential x
P. O. Box 1179 cr'3 PF z' $25.00 - Non-Residential
Southold, New York 11971 O ���'`,
Telephone "lei y1 '1D
P iritiLL,-:\ i
(516) 765-1801 °
FEB 201997 1
TOWN OF SOUTHOLD
BLDG DEPT
SOUTHOLD WASTEWATER DISPOSAL DISTRICT ..12
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ 10
DATE February 11, 1997
OWNER NAME: Charles & Deborah Avondet
OWNER MAILING ADDRESS: 24 Berger Street , Ronkonkoma, NY 11779
OWNER PROPERTY ADDRESS: 3755 Grand Avenue
Mattituck, NY
OWNER TELEPHONE NUMBER: 467-1979
TAX MAP NO. : Section 107 Block 1 Lot 5.2
CROSS STREET: Greton Court
1
TYPE OF SYSTEM: Septic Tank New X Existing
Cesspool New X Existing
Residential-,__ Non-Residential
LOCATION MAP: Must be attached hereto before permit may be issued.
(Locate building and system; give north arrow and feet
of distance, approximately, to building and closest road.)
melliLA i . .' OM • (-"--------
Signatur:• • pp icant
Richard 0ppe-r.. o, President
EAST ISLE CUS c BUILDERS,INC.
RECEIVED BY:
Town Clerk's Office
DATE:
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