HomeMy WebLinkAboutCavaliere, Fred c 0 ice
JUDITH T.TERRY ��� Town Hall, 53095 Main Road
TOWN CLERK ; y P.O. Box 1179
REGISTRAR OF VITAL STATISTICS O � Southold, New York 11971
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MARRIAGE OFFICER yFax(516) 765-1823
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RECORDS MANAGEMENT OFFICER =� i �,a0�/// Fax
(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. 1635 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : MODULAR HOMES HJR
Address 1 : 1691 SUNRISE HWY.
City St Zip SOUTHAMPTON NY 11968
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. SCHD REF. #R10-97-0039
Name Of Owner CAVALIERE, FRED
Mailing Address 1 C/O MODULAR HOME HJR
1691 SUNRISE HWY
City St Zip SOUTHAMPTON NY 11968
Property Address 1 BENNETT'S POND LANE
City St Zip MATTITUCK NY 11952
Tax Map No. section 113.00 block 13 lot 5.000
Cross Street WESTPHALIA ROAD
Building Permit Number Cross Reference:
Issue Date: 4/22/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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T^ANN OF SDoWn'tall,53095 Main Road
$#• y P.O. Box 1179
� �1�.f`„1 � I Southold, New York 11971
JUDITH T.TERRY , 4 _ TELEPHONE
•••••� �%�• ,/ (516) 765-1801
TOWN CLERK `
REGISTRAR Ot VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD /6 3
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: March 25, 1997
Transmitted herewith is a copy of application No. 1703 for a Cesspool/
Septic Tank Construction Permit submitted by:
Modular Homes HJR on behalf of Fred Cavaliere •
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.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE
• Comments:
RECEWED
Signature
APR 2 ? 1997 �/O//7
Dated
Southold Town CE4 '!.
OFFICE 0°F THE TOWN CLERK c.0FO( 0
Town of Southold
Application No. 1 o3
Judith T. Terry, Town Cleric g %
Town Flap, 53095 Main Road Construction
P. 0. Box 1179 y,, 4' ---
New York 11971 � ,��e'� Alteration
Southold,
Telephone 21410 $� Residential-- I/f_
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTIIOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
• DATE 3 5—LQ 7 -- _.---
APPLICANT NAME: fr 04 v r cJ►'`2 S -� ►V ! i___ __ _—___�____
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APPLICANT ADDRESS: /(0 ( r tinc,r5 {' rI wy
SEPTIC V 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 : FreJ C04sq 1+ er €. _
OWNER MAILING ADDRESS: tio F Cj i _ —
Ny 1) lar
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: (5-16
TAX MAP NO. : Section11 (V __. .Block13 _Do:.._.__Lot 00-5 (00_
CROSS STREET : W€€ PkIf-i
BUILDING PERMIT NUMBER CROSS REFERENCE:
)\r‘42{- ``oma,
Signature of Applicant
RECEIVED BY:
n erk's Office
DATE: `/fo7., /477 — — ---
1000-113.00-13.00-005.000
•
W-ES TPHALIA -
ROAD 1
SUFFOLK COUNTY DEPAR"iME2srT OF HEALTH S� I
V
LOT NO.9
MOAT POR APPROVAL O/CGNITRUC19CDi:FOR A ! 1j BBNNETT'S PDND
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F6I1i3[,T 01 LY ` r FILED JUNE 12,1970 MAP NO.5483
DATE
r� pct'? �.!KI ;," , c"J_ oG3? MATTITUCK
APPROVED ~ TOWI•1 OF SOUTHOLD
SUFFOLK COUNTY,NEW YORK
FOR Lk BEDROOMS1 IN.= 30 FT. FEBRUARY 12,1997
THREE YEARS FROM DATE OF APPROVAL. W
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GUARANTEED TO:
WELL.-
I \ / ` FREDERICK CAVALIERE
GLADYS LAVALIERE
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AREA=25,753 SQ.FT. j ,(33 o) 33.0>�- \ S< Southampton. NY 11968
C516) 283-1441
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Suffolk Co.Dept of Health Services
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PAUL T.CANALIZO. SURVEYOR