HomeMy WebLinkAboutAverell, Alfred Jr .CO FOUt'
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Town Hall, 53095 Main Road
%0, N. 44 P.O. Box 1179
to Southold, New York 11971
JUDITH T.TERRY FAX it..T s FAX(516)765-1823
TOWN CLERK TELEPHONE(516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 445 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : CHARLES ALLEN CONSTRUCTION
Address 1 : MANAGEMENT CORP.
City St Zip LAUREL NY 11948
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES3/8/88.
Name Of Owner AVERELL, ALFRED B., JR.
Mailing Address 1 5880 SOUND SHORE ROAD
City St Zip RIVERHEAD NY 11901
Property Address 1 LUPTON POINT ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 115.00 block 11 lot 22.000
Cross Street MARATOOKA ROAD
Building Permit Number Cross Reference:
Issue Date: 1/05/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
'' - $ Town Hall, 53095 Main Road
Q -° 'c' d P.O. Box 1179
JUDITH T.TERRY 1 r t •••es Southold, New York 11971
.�,v- - TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK _
-
TOWN OF SOUTHOLD -"g C r- / r;'rci, iL 1. I
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To: Victor Lessard, Southold Town Building Department '
i 4 OS '!
From: Linda Cooper, Southold Town Clerk's Office �J
BLDG. DEPT.
Dated: December 14, 1988 TOWN OF SOUTHOLD
Transmitted herewith is a copy of application No. 452 for a Cesspool/
Septic Tank Construction Permit submitted by:
Charles Allen Construction Management Corp. for Alfred B. Averell, Jr., Nominee
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 X
DISAPPROVE ' ��
Comments: cx.. 1 _ t y. a 0
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c 1r $ l Q am% .C. N .� _ c _ IA% $ i -
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Signature
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Dated
•
OFFICE OF THE TOWN CLERK OCj�FFO(x`,D
Town of Southold
Town Clerk � :` Application No.
Judith T. Terry, �- �
Town Hall, 53095 Main Road RI) Construction
P. O. Box 1179 CU •? .' � Alteration
Southold, New York 11971
%Telephone 01 i say Residential X
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ /G'
DATE necemhPr 14, 19RR
APPLICANT NAME: Charles Allen Construction Management Corp.
APPLICANT ADDRESS: P.O. Box 31, Laurel, NY 11948
SEPTIC CESSPOOL x
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
Single family dwelling.
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Alfred B. Averell, Jr. , Nominee
OWNER MAILING ADDRESS: 5880 Sound Shore Road, Riverhead, NY
OWNER PROPERTY ADDRESS: Lupton Point Road, Mattituck
TELEPHONE NUMBER OF CONTACT PERSON: 298-9157
TAX MAP NO. : Section 115 Block 11 Lot 22
CROSS STREET: Maratooka
BUILDING PERMIT NUMBER CROSS REFEREN E:_.
/ r
A.
Signature of Applicant
RECEIVED EREasveD
Town Clerk's Office
DATE: DEC 1 4 1988
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JOYNE FOST N32477
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iSUFFOLK CO. HEALTH DEPT. APPROVAL
•
H. S. NO.
STATEMENT OF INTENT
court DEPARTMENT OF HEALTH SERVICESTHE WATER SUPPLY AND SEWAGE DISPOSAL
FOR APPROVAL OF CONSTRUCTION 0 SYSTEMS FOR THIS RESIDENCE WILL
Single family Residence Only CONFORM TO THE STAN ARDS OF THE
y OS.? l SUFFOLK D T. O ALTH SERVICES.
OAT ...„,L13 _.—HS REF. i —1. --- (S) - u.
APPLICANT
APPR�Ea___.__61 •
11 SUFFOLK COUNTY DEPT. OF HEALTH
EXPIRES IWO YEARS FROM DATE Of APPROVAL SERVICES — FOR A PP R O V.A C OF
CONSTRUCTION ONLY ---
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App=('iv^.'i �enr..1:-., %f, w;!:$ 'oar�of l;.Ps.i w k
��•�• DATE:
drtarrt�ir+a +i(t4 H. S. REF. NO.:
. APPROVED: -
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SUFFOLK CO. TAX MAP DESIGNATION:
DIST. SECT. BLOCK PCL.
1 ►Joo H 5 1 t . 22.
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OWNERS ADDRESS:
'T---t---- . NOQTH Gam, • Bak` 41
MATTI TU I-Z N.Y 11952
i 29B-4777
I DEED: L.6472 P. 456 (REF.)
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RODERICK VAN TUYL, P.C.
LICENSED LAND SURVEYORS
GREENPORT NEW YORK
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