HomeMy WebLinkAboutKlunder, William c Sj FOL,.
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JUDITH T.TERRY Town Hall, 53095 Main Road
TOWN CLERK y Z 4 P.O.Box 1179
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REGISTRAR OF VITAL STATISTICS � ��, Southold,New York 11971
MARRIAGE OFFICER yifJDaQi' Fax(516)765-1823
RECORDS MANAGEMENT OFFICER c .( * � ��� Telephone(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. 1257 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : EAST ISLE CUSTOM BUILDERS INC.
Address 1 : 278 JAMAICA AVENUE
City St Zip MEDFORD NY 11763
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.
Name Of Owner KLUNDER, WILLIAM J.
Mailing Address 1 C/O EAST ISLE CUSTOM BUILDERS
278 JAMAICA AVENUE
City St Zip MEDFORD NY 11763
Property Address 1 OLE JULE LANE
City St Zip MATTTIUCK NY 11952
Tax Map No. section 122.00 block 10 lot 1 .000
Cross Street NEW SUFFOLK AVENUE
Building Permit Number Cross Reference:
Issue Date: 12/12/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY : Z ` L Town Hall, 53095 Main Road
TOWN CLERK : o T : P.O. Box 1179
IP � Southold, New York 11971
REGISTRAR OF VITAL STATISTICS "-104.46. •' Fax (516) 765-1823
MARRIAGE OFFICER _ .40-..�S' Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER ' W'K/1 ..
FREEDOM OF INFORMATION OFFICER =��„�,„i,���
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD le 17 In
TO: Southold Town Building Department O 1994
FROM: Linda J. Cooper, Southold Town Clerk's Office __ - -
DATED:
November 29, 1994
Transmitted herewith is a copy of application No. 1303 for a Cesspool/
Septic Tank Construction Permit submitted by:
East Isle Custom Builders Inc. for William J. Klunder .
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 C
Comments: SeilD ,
c .."—e"--- c_J,--/z/K--f---?
ItEctivED
_ /4DEC 91994
Signatur
Form Cmc Iia /. /�
Dated
• ;FIFE icF THE TOWN CLERK
Town of Southold Application No. 7 -9C)
Judith T. Terry, Town Clerk !
Town Hall, 53095 Main Road Construction
P. O. Box 1179 Alteration L/
Southold, New York 11971 Residential
Telephone
(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 (/ 2 C//
APPLICANT NAME: East Isle Custom Builders, Inc.
APPLICANT ADDRESS: 278 Jamaica Avenue
Medford; New York 11763
SEPTIC x CESSPOOL X
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
construction of single family awplling
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY : (4,1(1.1,4t& - _
OWNER MAILING ADDRESS:C4, �(d i� 1 Sly Ckbr0 �-:p -5
*A-Act-A 4rE.9 )(--(64Polz- Puy I/ 7&3
OWNER PROPERTY ADDRESS: ES Ole Jule Lane-99T S New Siiffo k Ave
MattitUck
• TELEPHONE NUMBER OF CONTACT PERSON: 727_6021 Rirhar0 '
TAX MAP NO. : Section 122 Block 10 Lot 1
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
LejletiLA .1
Signature f pplicant
RECEIVED BY:
404
Town Clerk's 0 ' e
DATE: ///0 /9 V
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EXPIRES THREE YEARS FROM DATE OF APPROVAL 6ivywzie,N.7,.
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