HomeMy WebLinkAboutLucarelli, Charles 1
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JUDITH T. TERRY :,'
Town Hall, 53095 Main Road
TOWN CLERK :Z. p r= •
IP.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = VO �. ��� Fax (516) 765-1823
MARRIAGE OFFICER - '`^ ��O •� Fax
(516) 765-1801
RECORDS MANAGEMENT OFFICER 7�/ 411 '.
FREEDOM OF INFORMATION OFFICER ,i,���
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1061 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : CHARLES LUCARELLI
Address 1 : 19105 MAIN ROAD
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. SCHD REF # 93-SO-57
Name Of Owner LUCARELLI, CHARLES
Mailing Address 1 19105 MAIN ROAD
City St Zip MATTITUCK NY 11952
Property Address 1 LUPEN DRIVE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 104.00 block 1 lot 1 .000
Cross Street SKUNK LANE
Building Permit Number Cross Reference:
Issue Date: 11/30/93 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
e v - /0 67
JUDITH T. TERRY < : Town Hall, 53095 Main Road
_ : P.O. Box 1179
TOWN CLERK z O T
REGISTRAR OF VITAL STATISTICS tri
� Southold, New York 11971
MARRIAGE OFFICER yQ �' Fax (516) 765-1823
� Po*
Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: November 8, 1993
Transmitted herewith is a copy of application No. 1093 for a Cesspool/
Septic Tank Construction Permit submitted by:
Charles Lucarelli •
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: :S ,/D illy.71 93— S 4 -5T7,i-7-f/0,n
NOVwive
: ,
Signatur
?per ft bell /A-
Dated
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OFFICE OF THE TOWN CLERK cVr-Fri-
• Town of Southold ,.- ` Lr i -t.
Judith T. Terry, Town Clerk E '`
�• � • Application No/d q3
Town Hall, 53095 Main Road c t.r : . '• -." /
P. O. Box 1179 v' �'�`' Fat. i---;77 Construction ✓Southold, New York 11971 �` ca• Alteration
Telephone 1 i T Residential
(510 765- 1301 . �1rJf>7
Non-Residential
TOWN OF SOUTHOLD
•
•
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
•
APPLICATION RECEIVED . .
•
for ...NOV -i693,
CONSTRUCTION or ALTERATION PEP,llthord down Clerk
•
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$ • •
. DATE ,— ,5
•
APPLICANT NAME: /7
APPLICANT ADDRESS: ,45—. /41,42/;t/ /
J
• it / . .e. . 4 [ S.
SEPTIC CESSPOOL ✓
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
•
LOCATION MAP: Must be attached hereto before permit maybe _issued.
ssued.
LOCATION OF PROPOSED CONSTRUCTION. OR ALTERATION:
• OWNER OF PROPERTY: e,,�
•
• OWNER MAILING ADDRESS: • /d'S /A/ //
OWNER. PROPERTY ADDRESS: 4(.17°Eft...) 0
TELEPHONE NUMBER OF CONTACT PERSON: 9 A
TAX MAP NO. : Section /6 y . Block_l_Lot /
•
. CROSS STREET: �,Z
BUILDING PERMIT NUMBER CROSS REFERENCE:..
.
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Sic na �'
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plicant
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RECEIVED BY: • 1
Tow i erk's Office
DATE: 1/ - 01- q3 •
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F SUFFOLK CO.HEALTH DE'[•T.'APFRO L
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t 4a 4ts t } Y� „ : H.s. NO. r'�9•S
�.r 'r t yy, ,fit '` t' x + - ? s • - $ +t
, ~` }, r ,- 3 oto.: MAP OF PROPERTY''
It. M
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c r bft
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EYE FOR_
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fit'
P (VACANT) CHARLES 0 JOAfv
` * ; STATEMENT OF INTENT
i WATER SPLY AND SEWADPOSAL
rA• 'f L L�{{t�, 1;�{Y r SYSTEMS FOR THIS RESIDENCE WILL
M CONFORMTHE TOUPTME STANDARDS
GE OF ISTME
'r� - !-T-- AT SUFFO O. D�q OF ALTHSICES.
�r ' I CUICHOGUE' ( / 'e
APPLICANT %�
` . e .1.3• :SO' TO‘� 1,..1 OF SGJTHOLD NY,
WREN. DRIVE �e 1 SUFFOLK COUNTY DEPT. OF HEALTH
SERVICES — FOR APPROVAL FOR
f 'BAY AVEAlVE . N. 12''50 E. 135.0 .,,, I + CONSTRUCTION ONL1 G �r 4 '1���
fa/ t - I r prop. +a• DATE:
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�,fn 4 _ / _ _.L� -• • SUFFOLK CO.TAX MAP DESIGNATION:
i, r;P ` tf ,! • 6 • DIST. SECT. BLOCK PCL.
• y7y 4 1: . :l:: �_ 1000 tC4 1 1
ri, 1 - �. .. OWNERS ADDRESS:
t ff'' /II•rt I .,1 ---.. PIIOP HOUSE -- 35 I 19105 NIAIN 2QA&- /. tHG. MAT'TITUCk/N.Y 1:952
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CQlntEs DEMP5E'f' AMENDED AUG.20, (993
02e. `-5- O •gp0ONlZIO 1 r VAc.ANT) 9t: -- OCT. 27 1993 o F 1609:
(REST) ` t` CY
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f.LQT N0 5.REFER TO MAP OF 1;tCt�A2`r AC2ES� \ A5 SURVEYED ..,uNle t8 1993 0 '.- sessa o,
FLED IN f 4E SUFE CA.Ct_Et2iC'S OFxlGE AS MAP NO.3325• RODERICK VAN TUYL.P.C. 1\ -0 ��s�m`�D
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LICENSED LAND SURVEYORS
' CGc+o1.r f"• ,r.P001... \ OREENPORT NEW YORK
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