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JUDITH T. TERRY o 'ffE
. , Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS � Southold, New York 11971
MARRIAGE OFFICER �� N..tv Fax (516) 765-1823
=_ ��® ����! Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 887 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : TORKELSEN BUILDERS
Address 1 : CLIPPER DRIVE
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLIN AND CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 6/26/92.
Name Of Owner PERKINS, RICHARD AND BETSY
Mailing Address 1 P. O. BOX 224
City St Zip ORIENT NY 11957
Property Address 1 240 ORIOLE DRIVE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 55.00 block 6 lot 15.013
Cross Street TUTHILL ROAD EXT.
Building Permit Number Cross Reference:
Issue Date: 7/20/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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' Town Hall, 53095 Main Road
JUDITH T. TERRYea C.
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( '� P.O. Box 1179
TOWN CLERK ® {��
REGISTRAR OF VITAL STATISTICS k' Southold, New York 11971
' Fax (516) 765-1823
MARRIAGE OFFICER VP; i7- '
��®��41 Telephone (516) 765-1801
407
OFFICE OF THE TOWN CLERK
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TOWN OF SOUTHOLD o �
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Southold Town BuildingDepartment � 1 ML 0 4199? I s`,
TO: ri ii
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FROM: Linda J. Cooper, Southold Town Clerk's Office ILL -t 4, _ _
DATED: July 14,' 1992 -_ RLF' _ ;-` ` .
Transmitted herewith is a copy of application No. 911 for a Cesspool/
Septic Tank Construction Permit submitted by:
Torkelsen Builders for Richard and Betsy Perkins .
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.
'9Cf- 4-86-4`" -
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations: ,
APPROVE 'K,
DISAPPROVE
Comments: q� C. ,
IstN
LAVAACk _.
A,C. T"1. ` ,.• 0
Signature
_ _ —111 1 --.\\--.\\>......Dated
;OFI^`CE OF THE TOWN CLERK � FDI-rfe:;
Town of Southold 0�� f �O
Judith T. Terry, Town Clerk �� �` y Application No. G G�
Town Hall, 53095 Main Road o i'`' - Construction
P. 0. Box 1179 �i; `
Southold, New York 11971 c• C Alterationgyp;' .
Telephone 1 r1 Residential
(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 $
DATE ' ) 3 -
APPLICANT NAME: TOR TORKELSEN (TORKELSEN BUILDERS ) by PAUL A. CAMINITI
A'T'TORNEY
APPLICANTADDRESS: Clipper Drive, ' Southold, New York 11971
SEPTIC )Q CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION ,leu /
i
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: re:lc� __re.rcrc
OWNER MAILING ADDRESS: IC)• 'C:5, , RUQ oLl
OWNER PROPERTY ADDRESS: Q-
TELEPHONE NUMBER OF CONTACT PERSON: • l& ^ /i0/
TAX MAP NO. : Section ,3 S Block . Lot
CROSS STREET: �1-A,'/) -'K7 �n I 6,‘4., z
BUILDING PERMIT NUMBER CROSS REFERENCE:. -
f/'
•
of Applic nt
RECEIVED BY:
, Vv l ,
T wn Clerk's Office
DATE: `7/l •
.
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Prepared in accordance with the minimum
SUBDIVISION- MAP OF YENNECOTT PARK slandards for title surveys as established
SUFFOLK COUNTY FILE N0 5187 _ by the L.I.A.L.S. and approved and adopl�<
e//n for such use by The New York Slate.Land
ervve//,;y 9 Title Association. tr,
' (P-bi,c, wa.,cr - F /P"b/c watcrJSp/if raw/ ••.• ''�
) /. / le'''`. it
N. 88' 57'30'E. i o /05.66' o'
325 sec
12'O` 397 Set CERTIFIED TO.
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BETSY PERKINS
RICHARD PERKINS
SI,
Z 11
N LOT .
N 10 LOT •
LOT �� e
T1 •-k.
AREA=21,712 sq.ft. N
SINGLE FAMILY DWELLING ONLY
EXPIRES 3 YEARS FROM DATE OF APPROVAL
Pr
N
-
SURVEY OF '
--I
LOT 10
"HIGHPOINT MEADOWS"
se'4:. J
n y SECTION TWO .
Z BLED MAR 19,1990 MAP NO 8971
Y-' P Ph'', rr 4a' 234 • - .
Z AT SOUTHOLD
23 4 •` o TOWN OF SOUTHOLD
3' . ( aN Q
SUFFOLK COUNTY, N.Y.
u o1000-55-06- 15.13
• SCALE 1"= 30'
I
Mar. 25, 1992
uln •
31,G , .2.warn
105.00'
�c .9 82' 34'20' W.�— �//i D((�! yoT o E — •• tAP3R S,,
e
DRIVE ^ SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES i'p'c�'N =CF F�
FOR APPROVAL OF CONSTRUCTION ONLY /- • tO
` Foj i�`� N.P4' LIC. NO. 49618
' ORIOLE The wafer supply and sewage disposal ,i�'.#_�r, I
systems for This residence will conform, DATE____ __HS.__ 19�zw`•REF.NO. 9' O 6 "EC'• '7• •- i P.C.
( v c' `.`-•,,t) to the slandards of The Suffolk County i _ (5161\ j9 ot•/
Department of Health Services. '� r . P. O. \'-:1!(.141.1.6_':_,-,/•
ASSUME/ONS ARE REFERENCED TO AN APPROVED �� /`, AIN R•
ASSUMED DATUM. - 0 THOLD, N.Y. 11971
92-138 -