HomeMy WebLinkAboutMalpiedi, Charles '�
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ELIZABETH A.NEVILLE *�`Z` t%‘ Town Hall, 53095 Main Road
TOWN CLERK % p - . % P.O. Box 1179
ti Z % Southold,New York 11971
REGISTRAR OF VITAL STATISTICS Z W '
MARRIAGE OFFICER • � 1 Fax (516) 765-1823
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RECORDS MANAGEMENT OFFICER ; �d 00.0Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER ��
s, of
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1886 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : QUALITY CRAFTED HOMES INC.
Address 1 : 175 MONTAUK HWY.
City St Zip WATER MILL NY 11976
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 #R10-98-0032
Name Of Owner MALPIEDI, CHARLES
Mailing Address 1 79 VIOLET AVENUE
City St Zip FLORAL PARK NY 0000
Property Address 1 150 OLD FIELD CT
City St Zip MATTITUCK NY 11952
Tax Map No. section 120.00 block 3 lot 8.028
Cross Street FARMV I EW ROAD
Building Permit Number Cross Reference:
Issue Date: 7/10/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
„o,�S�FFO�,rco ���
- ELIZABETH A.NEVILLE G`
y Town Hall, 53095 Main Road
TOWN CLERK ; p - %' P.O. Box 1179
REGISTRAR OF VITAL STATISTICS •1, Southold, New York 11971
MARRIAGE OFFICER �� *. • Fax (516) 7654823
RECORDS MANAGEMENT OFFICER 0.� �0 Telephone (516) 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:
Transmitted herewith is a copy of application No. 1960 for a Cesspool/
Septic Tank Construction Permit submitted by:
Quality Crafter Homes, Inc. for Charles Malpiedi •
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 E/
DISAPPROVE
Comments:
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natu e
Dated
OFFICE OF THE TOWN CLERK ',, 01./
TOWN OF SOUTHOLD ���Q Ql/ Application No.� �G
ELIZABETH A.NEVIIIF,TOWN CLERK �%,,,
P.O.BOX 1179iO ! Construction �^
SOUTHOLD,NEW YORK 11971 Z
Alteration
Telephone D,j 'i�, • $10.00 -Residential
(516) 765-1801 - ,10. •
$25.00 -Non-Residential
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE ( �
1
APPLICANT NAME: "' -/ Lti1 C� j%jZ� ✓��� l�-C-
APPLICANT ADDRESS: r75— 1 t iv Ymt �-✓�l
SEPTIC /CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATIpN
SC 1L SS T-
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: q kpi±y
OWNER OF PROPERTY: ON/Ole-5 NA .....KaLp(
OWNER MAILING ADDRESS:7 L/j0t-tr(" f vtr
emc < " 1
OWNER PROPERTY ADDRESS: /c-0 OLP f'(&-y Cr
/`t 7v t_G Z
TELEPHONE NUMBER OF CONTACT PERSON: 7Z‘r3Q0
TAX MAP NO. : Section /-Z-0 Block U Lot O. Z
CROSS STREET: I r4'b- t4.6-1.2 !2P
BUILDING PERMIT NUMBER CROSS REFERE
//
Signat / of Applicant
RECEIVED BY: *AL--e----"<__e_
Town Clerk's Office
DATE: ��,/1 6/
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„a„, I 'FOLK COUNTY DEPARTMENT,OlE I 6LTH SERVICES
toT i
VAL-A-as(' PERMIT FOR APPROVAL OF C lI
SCI'ION FOR A
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5 C E FAMILY RESIDENCE ONLY
bATE / 9 NO. / '/U-97 -oc�J3 .R
THE!LATER SUPPLY&SEWA E
APPROVED .�i/0I>j't
DISPO4l^,L FOR c THIO `" DENCE
IL .,.OM TO IF ,, FOR MAXIMUM OF BEDROOMS
W•
ARDS OF THE IE SL°FFO
S < COWS THREE YEARS FROM DATE Of APPROVAL
EIISI l 1►�Gd �Tu" DEPT.OF HE/:LTH SERVICES. .
Unauthorized alteration or addition to this document is a violation of Section 7209 SURVEY OF: L.c.-T-- z(p
of the New York State Education Law. �/�►
Certifications eindicated hted hereon shah run onlyto e person for whom it is prepared '" y\1 0� �� t`4, r •l�' . , A
and on his behalf to the Title Company,Governmental Agency and Lending LI //"��(�N(•[[// 7'�
Institution listed hereon,and to the assignees of the lending institutions or subse-
quent AAA-Tri T1iLI - � /4 6 4'
Copies of this document not bearing the professional's inked seal or embossed
seal shall not be considered a valid true copy. y �T .. ` ��
,
The offsets(or dimensions)shown hereon from structures to the property lines are ��1N l i/ &le ry Y
for a specific purpose and use and therefore are not intended to guide the erection of 1 I ��,VVV
fences,retaining walls,pools,patios,planting areas,addition to buildings or any other
construction.
The existence of right of ways and/or easements of record,k any,not shown are �. Os // /
not guaranteed. Q� . - •iv 'TE: I 14 10 SCALE: I ; SD
a DEE1.7. k..<-.,.::':,
CERTIFIED ONLY TO: • , I �' r r ' -Cr"1'' DESTIN G. GRA
P----Y� L - ED( "NIA A LP3k VSA 7( i`�` -eceived III
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'.' LAND SURVEYOR.ff,: CntiR y i
MAR 0 3 199,4 1
By 1 /' 73 WOODLAWN R969 • `
DESTIN G.GRAF N.Y.S.LIC No.50067 /` ROCKY POINT,NEW YOk; `,,`�i ') ��e 9•es
PHONE(516)821-02:.„... ..... SfBWBTP.r R�(7fT)t. ,
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