HomeMy WebLinkAboutGusmar Realty (2) ,ge gtFFOLt
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JUDITH T.TERRY ��_� ?1`� Town Hall, 53095 Main Road
TOWN CLERK ; y Z P.O. Box 1179
REGISTRAR OF VITAL STATISTICS %."4 $ Southold, New York 11971
�� � Fax(516) 765 1823
MARRIAGE OFFICER `y
RECORDS MANAGEMENT OFFICER '.1 ��O'�� 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. 1562 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : TIMOTHY COLLINS
Address 1 : 27 JOSHUA EDWARDS COURT
City St Zip EAST HAMPTON NY 11937
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.#R10-96-0094
Name Of Owner GUSMAR REALTY CORP.
Mailing Address 1 13 15 37TH STREET
City St Zip LONG ISLAND CITY NY 0000
Property Address 1 SHIPYARD LANE
City St Zip EAST MARION NY 11939
Tax Map No. section 35.00 block 8 lot 5.005
Cross Street MARINA LANE
Building Permit Number Cross Reference:
Issue Date: 11/01/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY ���_� 'yl`� Town Hall, 53095 Main Road
TOWN CLERK ;• y P.O. Box 1179
REGISTRAR OF VITAL STATISTICS O 47 1 Southold, New York 11971 _
MARRIAGE OFFICER �die
�.
Fax
Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER 0l �.a0011Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER so°
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
./ 4
TO: Southold Town Building Department
FROM: Linda J. Ccoper, Southold Town Clerk's Office
DATED: October 24, 1996
Transmitted herewith is a copy of application No. 1626 for a Cesspool/
Septic Tank Construction Permit submitted by:
Timothy Collins for Gusmar Realty Corp.
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 Z//
DISAPPROVE / ,
Comments: l / Ay/6)0 ,94- (N�y�9P
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Sig• .ture
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Dated
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OFFICE OF THE TOWN CLERK goo! ••••.,�U(
Town of Southold ��"I\\ •
Judith T. Terry, Town Clerk ��' � �/ ; Application No.�(P '246'
Town Hall, 53095 Main Road L Construction
P. O. Box 1179 r cza —
Southold, New York 11971 i � Alteration
Telephone %P
$10.00 - Residential
(516) 765-1801 ift $ •
.[t ,i $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTIIOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE October 21 , 1996
APPLICANT NAME: Timothy Collins, AICP agent for Gusmar Realty Corp.
APPLICANT ADDRESS: 27 Joshua Edwards Court, East Hampton, NY 11937
SEPTIC CESSPOOL g
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION Proposed
single family residence to be serviced by public utilities .
LOCATION MAP; • Must be attached hereto before permit may be issued.
LOCATION OF PR(>�POSED CONSTRUCTION OR ALTERATION;
OWNER OF PROPERTY; Gusmar Realty Corp
OWNER MAILING ADDRESS: 13 15 37th Street, Long Island City, NY
OWNER PROPERTY ADDRESS; Shipyard Lane
East Marion, Southold
TELEPHONE NUMBER OF CONTACT PERSON: ( 516)329-5930
TAX MAP NO. : Section 35 Block 8 Lot 5 .5
CROSS STREET: Marina Lane
BUILDING PERMIT NUMBER CROSS REFERENCE :
• Crature o Applicant
RECEIVED BY ;
'Tfmi'' Office _
DATE; OCT 2 4 1996 .
hmfl Mit Southold
I
li /
ATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS MUST'
.1 ' ,1 te-IvN , Ifr - 6,,pinfict,g2 , / . 6'i , 1\1-1- . •RM WITH NEW STANDARDS DATED NOVEMBER 13,ice.
SUFFOLK COUNTY DEPARTMENT OF IffiALTIi BaRVIC!S 1
•
�f , GCT `i> '! R APPROVAL AP POR A
SINGLE AMILY RESIN:210E ONLY
DATE a / r r� . • a L L 1e4 f
B1 Z•$� FOR MAXIMUM OP TICROOM3
''s-' (�I-' 08`� EXPIRES THREE'YEARS FROM DATE OF APPROVAL
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