HomeMy WebLinkAboutKings Bay Partnership •
:.OFFICE OF THE TOWN CLERK c0FOCK`,
Town of S•uthold O!/
Judith T. Terry Town Clerk .` '
Town Hall, 530'5 Main Road
P. 0. Bo 1179
Southold, New York 11971 O O�•'�;
•
Teleph.neOl Agt
(516) 76' 1801 '
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCT ION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 200 Residential X
Fee $ 10.011 Non-Residential
Septic Cesspool X
PERMIT ISSUED TO:
NAME: Matthew McCaslin
ADDR:SS: 850 Bayhome Road
Southold, New York 11971
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling with Sanitary System
Approved as per Suffolk County Health Department approval.
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Kings Bay Partnership / Elizabeth Thompson
OWNER MAILING ADDRESS: 316 Mott Street, Apt. 3B
New York City, New York 10012
OWNER PROPERTY ADDRESS : ROW:_,off King Street
Orient, New York
TAX MAP NO. : Section 27 Block 3 Lot p/o 4
CROSS STREET: King Street
BUILDING PERMIT NUMBER CROSS REFERENCE: Pending
Judith T. Terr
Southold Town Clerk
DATE: July 13, 1987
(TOWN SEAL)
1 ( LZ i�f7(
o PUII
` `4 6Lo
' � BLD . OEp�
p TOW O c9O1i11110.,05309, Main Road
=o .,.;14 `,S 6 0 P.O. Box 728
-`� 04 ' Southold, New York 1 1971
JUDITI1 T.TERRY TELEPHONE
• TOWN CLF RK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
JUly 8, 1987
To: Victor Lessard, Southold Town Building Department
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy of application No. 202 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by Matthew McCaslin/Kinqs Bay Partnership. .
Please review the application and location map and advise if the
project has received Suffolk County Health Department approval
and if we may issue the permit.
Please complete the form below and return it to my office.
Thank you.
torr •
ided
Judith T. Terry
Southold Town Clerk
* * * * * * * * *
I have reviewed the application and location map of the project
cited above and make the following recommendation:
APPROVE -
DISAPPROVE -
COMMENTS: Q.0 k a..M.: 1'
Signature
11 91 8 '1
Date
OFFICE OF THE TOWN CLERKS1F1UC
Town of Southold .*4 Application No& 2
Judith T. Terry, Town Clerk r
Town Hall, 53095 Main Road Construction
P. O. Box 1179 �4 Alteration
Southold, New York 11971 , Y�-
Telephone Vl t ��; ." Residential
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ 10
DATE 0I \1667
APPLICANT NAME: g tAll HEW
APPLICANT ADDRESS: 4)S-0 i r
c O ci `t'I� 0 c_,N
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Q (c)
L_t z -r k\O,..AP�,.1
OWNER MAILING ADDRESS: \ -1\,c(' AO .
`k C_ `‘) . ` c) O ( 7
to LJ 64- Ki ,vCei S7—
OWNER PROPERTY ADDRESS: �,���� A 3
D �� t✓�r, v �{ per- C, -
TELEPHONE NUMBER OF CONTACT PERSON: SIS - "7(p'5 j5 - 7
TAX MAP NO. : Section 02 / Block Lot y'
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE: P� _1D `Q(°
A.
Signature of Applicant
RECEIVED BY: �cc
R Ce,vien erk's O fice
DATE:
JUL 081987
Town Clerk Southold
•SUFFOLK CO. HEALTH DEPT. APPROVA
H. S. NO.
/47; .5•.. - - .
SINGLE FAMILY DW LLING ONLY
EXPIRES TWO YEARS FROM ATE OF APPROVAL •
STATEMENT OF INTENT
THE WATER SUPPLY AND SEWAGE DISPO'.
4 = SYSTEMS FOR THIS RESIDENCE v.
CONFORM TO THE STANDARDS OF
y t 'i•l 3 r r� yr.:_ SUFFOLK �a•. T. • HEALTH SERVI •
(S)�I fto_ XIJf
APPLICANT
SUFFOLK COUNTY DEPT. OF HE
SERVICES - OR/ APPROVAL
CONSTRUC I• • j4
DATE:
� 7
H. S. REF. NO
• v -ion
APPROVED • .'drz1/76 %ad,
SUFFOLK CO TAX MAP DESIGNATIc-)r,
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