HomeMy WebLinkAboutMcKiernan, Matthew (2) 4
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JUDITH T. TERRY Z : Town Hall, 53095 Main Road
TOWN CLERK Z. O T P.O. BOX 1179
REGISTRAR OF VITAL STATISTICS ir2 $ Southold, New York 11971
MARRIAGE OFFICER yQ O�' 1 Fax (516) 765-1823
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(516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1033 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MATTHEW MCKIERNAN
Address 1 : P. O. BOX 1637
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY RESIDENCE.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES 7/8/93.
Name Of Owner MCKIERNAN, MATTHEW & JOSEPHINE
Mailing Address 1 P. O. BOX 1637
City St Zip SOUTHOLD NY 11971
Property Address 1 PRIVATE ROAD (K I ELBASA ALLEY)
City St Zip PECONIC NY 11958
Tax Map No. section 86.00 block 5 lot 11 .005
Cross Street INDIAN NECK LANE
Building Permit Number Cross Reference:
Issue Date: 8/04/93 Judith T. Terry
Southold Town Clerk
[TOWN SEAL)
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JUDITH T. TERRY Town Hall, 53095 Main Road
T P.O. Box 1179
TOWN CLERK t
REGISTRAR OF VITAL STATISTICS tri
Southold, New York 11971
MARRIAGE OFFICER yQ ��0�" Fax (516) 765-1823
•�' Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
AUG - 21993
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office 8��+�• �� s. q
TOWN OF SOLM-491.11
DATED: August 2, 1993
Transmitted herewith is a copy of application No. 1063 for a Cesspool/
Septic Tank Construction Permit submitted by:
Matthew McKiernan •
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
Comments: SC ID ,yri,o 7#4.3 93-50 -614
AUG 31983 Signature
1 (adtSOO 143
Dated
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OFFICE OF THE TOWN CLERK , Oc�\;i-F- k', _
• Town of Southold �. ,.. . `�� '� U
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Judith T. Terry, Town Clerk J!:r;^ LL: V ` 4..,11 Application No.
Town Hall, 53095 Main Road ctfl ��,: ` Construction ��
P. O. Box 1179 �>
Frr.i..,.
pnp�• ^1' , Alteration
Southold, New York 11971 -•-,% 07 v
Telephone "�l xIt fl-f Residential v
(516) 765- 1301 ' " Non-Residential
• TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT .
APPLICATION
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•
CONSTRUCTION or ALTERATION PERMIT • ,
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ /0,019
DATE . ,` v7'93
APPLICANT NAME: `0;477 //tocJ eiscJ.,�'
APPLICANT ADDRESS: /p 80 x /4 37
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SEPTIC IV/CESSPOOL
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DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION l„� O,-.cS/v 'c r
-iA/l A° Al k!12 /F'S/G//9, IC e' •
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: r
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OWNER OF PROPERTY: 9 �rc� hew, e `�erN44)
OWNER MAILING ADDRESS: Po epic:. 16.27
_...5--Uc)%, idi / //97/
OWNER PROPERTY ADDRESS: Pr(u4 re cl (IkW ire /jAJ4 g/ J) •
P-e3 / N5� /
TELEPHONE NUMBER OF CONTACT. PERSON: X77l/c 3
TAX MAP NO. : Section ,,F6 Block Lot //,c .
CROSS STREET: i A,v -cc I4 •
BUILDING PERMIT NUMBER CROSS REFERENCE:..
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-.Zrd-------; ,• Signature of�App cant
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RECEIVED BY : 1 .-
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Town Clerk's Office •
DATE: •/ j 3
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