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Home My WebLink AboutKohlmeyer, Henry • • i OFFICE OF THE TOWN CLERK c FU(x`, Town of Southold ( Judith T. Terry, Town Clerk Town Hall, 53095 Main Road P. O. Box 1179 WS' Southold, New York 11971 ��•'. Telephone � t (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 11 Residential XXX Non-Residential Fee $ 10 . 00 Septic XXX Cesspool PERMIT ISSUED TO: NAME: INLAND HOMES a/c Henry Kohlmeyer ADDRESS: 315 Westphalia J2nad Mattituck, New York 11952 DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION New System LOCATION OF PROPOSED CONSTRUCTION or ALTERATION: OWNER OF PROPERTY: Henry Kohlmeyer OWNER MAILING ADDRESS: 315 Dean Drive Cutchogite , New Ynrk 11935 OWNER PROPERTY ADDRESS: same TAX MAP NO. : Section 116 Block 05 Lot 5 CROSS STREET: New Suffolk Lane BUILDING PERMIT NUMBER CROSS REFERENCE: 15136 Z • Judith T. Terry Southold Town Cler DATE: August 11 , 1986 (TOWN SEAL) _I , _ , • • S�FFO(�-' `J 1�. 45 5M1 0y ; Town Hall, 53095 Main Road lit=_.;. % ��`/ P.O. Box 728 ©1 JP 1% 00. Southold, New York 11971 JUDITH T.TERRY ''�•,.,•. oils TOWN CLI:R1: TELEPHONE (516)765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To : Victor Lessard, Southold Town Building Department ' From: Judith T . Terry, Southold Town Clerk Transmitted herewith is a copy of application No. / / for a CONSTRUCTION or ALTERATION Permit for a cesspool or s ptic system submitted b y Robert Hiltz,Inland Homes. Inc. a/c Henry Kohlmeyer . Please advise if the project has received Suffolk County Health Department approval and if we may issue the permit . Ju ith T. Terry "644/1; ---"".. Southold Town Clerk Attachments a /14 ;t:) -4 /'/V4f7i)‘---- e'er. a..i./. -:..,i...• --44/LAI,..±..........,Q.1-,-,.-,7-,:,/4 1TOWN CLERK i TOWN OF SOUTHOLD I Suffolk County, New York 516 - 765-1801 I. 0 14 4 69 ! Southold, N. Y. 1197 1 1 ' i a- I I '‘1)..h..V....-..,n-A, .*49.)47q1-/-"i• 41-11e ' /�iJ Dollars sJj2 t For _ �. Ca _. { V �\ ' ' ' f Judith T. Terry, To,n Clerk/ ' Cash Q Check [tom# // • • OFFICE OF THE TOWN CLERK Town of Southold ) Judith T. Terry, Town Clerk Application No. Town Hall, 53095 Main Road Construction P. O. Box 1179 Southold, New York 11971 Alteration Telephone 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 O �- , ) g' � APPLICANT NAME: APPLICANT ADDRESS: ) 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: �• ,—„�__,,,�`Alc ,_ OWNER MAILING ADDRESS: '%,) � > y c' OWNER PROPERTY ADDRESS:____ ��-�-�--�-- TELEPHONE NUMBER OF CONTACT PERSON: 9 lam" TAX MAP NO. : Section ) i Block p c Lot , CROSS STREET: (/ ��,,.. 3 oa i 3. "")1-,e-c.....14,61/3i,,-4- BUILDING ua..�. .^- BUILDING PERMIT NUMBER CROSS REFERENCE: 1 .5 )3 Z 4 4Signature o Applica RECEIVED BY: -.NW// •wn lerk' Office DATE: e 1� _...._ . _ •7 o_..„........,...., , )..--c.....4...J • . . • / . . . . , N / , 1,..(,)tr- •-.1/ '' ; -,-,, .. • .%' °*.' ) ' b0 -,- . if• .::)." 0 , 1 , •••-, / - ? V VA °9‘1 ' 1 ' f/L't•A,1 i t ‘0_,,lide"-- •c --)..,„-- \ 1 / / / , ___ , t oft„'el%•. , / :• ,*----- . , _., i ...., . 4.... ."-4... /., c. .--- a pf‘,/ .)." . :,a, ),--,..-...4 I•2 ! ' TO IV ' V"•1""'....4 Ala #' /,/,,, : ' IN =---) ; • 8. I ' ...d,,_,: , r- , to-• I 0 I ' . ' ,.,%' / ei. 0 Lc x • , :g,,,,1 -I ---- /,.." :•-, i ; , , -7 f I - Irc CT\ i 3 6.1 • 1'-3 0 - i --; -t- 196.93 4/2 •... \ ,r)i .. , ._ . The locations of the water supply andfor \. •sewag ., e dispqsal facilities on this property have not been verified. \ \ \ 1 \ . . \ _______ • . LOT i1/4.105. 12EREUZ -7(;) MA1*-- ',Dr ,,....x.ivit\r‘Vii -, .,-.,‘ , i- t •_ . L..„ , 7)-11- iv.._ -1 F, CO3CLE't.1,17"":" 1 1 'e - _ . ,i , (._ . mAi_., ; ,4•,:,, c,:ty.:,ii.)•:), • DYNE POST N61239 • . .