HomeMy WebLinkAboutGusmar ELIZABETH A.NEVILLE deLt, 4. Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold,New York 11971
MARRIAGE OFFICER `� O ��', Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER = "�®�/ ���' . Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
SOUTHOLD TiANSIREIVOlEIRTHINFIIDSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2565 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : GUSMAR REALTY CORP
Address 1 : 13-15 37TH AVENUE
City St Zip LONG ISLAND CITY NY 11101
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-00-0119
Name Of Owner GUSMAR REALTY CORP
Mailing Address 1 13-15 37TH AVENUE
City St Zip LONG ISLAND CITY NY 11101
Property Address 1 MARINA LANE
City St Zip EAST MARION NY 11939
Tax Map No. section 35.00 block 8 lot 5.014
Cross Street SHIPYARD LANE
Building Permit Number Cross Reference:
Issue Date: 5/01/01 Elizabeth A. Neville
Southold Town Clerk
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(TOWN SEAL)
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ELIZABETH A.NEVILLE "�"�� �� 40; Town Hall, 53095 Main Road
TOWN CLERK ; :-- P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ', ovv Southold, New York 11971
MARRIAGE OFFICER �����, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ,ss22,, ��®•�i� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER _ `z s'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: April 24, 2001
Transmitted herewith is a copy of application No. 2655 for a Cesspool/Septic Tank Construction
Permit submitted by:
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.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments:
£ure
I 3 (
Dated
'sr OFFICE OF THE TOWN CLERK ��e'c�,'cC r v/►•
TOWN OF SOUTHOLD '�'�OJ�`` OLn`�`` Application No.a`��
FTj7ABETH A.NEVILLE,TOWN CLERK 7�
P.O.BOX i179 % Z; Construction
SOUTHOLD,NEW YORK 11971
'::3crIT Alteration
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Telephone 0,�� �bigri $10.00 - Residential
(631) 765-1800 =— * ,��' $25.00 -Non-Residential
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TOWN OF SOUTHOLD •
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
•
APPLICATION
for RECEIVED
CONSTRUCTION or ALTERATION PERMIT APR 2 4 2001
SEPTIC TANK or CESSPOOL 1'11101E0 town Clerk
Permit No.
Fee .$
DATE V2_4/6/
APPLICANT NAME: ,'y1c R CR-LIT
APPLICANT
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APPLICANT ADDRESS: 1 -5 - /S 3 7.-/-/-1 UP
(-7 - `( 1 ( to1
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
1� ca 1.0 C6v`)5T/Zt770 fU
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
• OWNER OF PROPERTY: G-C 3-,i7'Th t / L7-'-[ c-0,.3
OWNER MAILING ADDRESS: / - /s ?> 7t/l Ac''
L . lc k_ y 1 / /o /
OWNER PROPERTY ADDRESS: `MVO 140 L A-
hipp ( Dak fes. {
TELEPHONE NUMBER OF CONTACT PERSON: ( Y" --4v5
TAX MAP NO. : Section =3 S Block Lot S . f 1
CROSS STREET: {---10 �i ? LA
BUILDING PERMIT NUMBER CROSS REFERENCE:
•
-
Signa
Signa ure o' Applicant
RECEIVED BY: •
Town Clerk's Office
DATE:
°lie\°~ HEALTH DEPARTMENT USE
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G6 e/. c>,,,o
��c �° �° SUFFOLK COUNTY DEFA. f OF HEALTH SERVICES
�J �o �� APPROVAL OF CONSTRUCTION FOR A
J� .�� o~� 3"E SINGLE FAIOrIIILY ONLY
� � otQ oc�; s 0S, co �� �J\Atm AeF.I4O• ,10 ,D ,
oto G tis '> ��, —
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0c APPROVED
o ��� 560� Bg®ROOB+IS
of ,o°° <v ,� 'LrO f FORM OF--..-
�� Jo o,o +itaimi221 y ARS DATE OF APPROVAL
7, f
ZN A1S 0� . THIS PLOT PLAN WAS PREPARED M OFFICE DATA AND FROM
(° �a9. �9 <° INFORMATION SUPPLIED BY THE DEVELOPER. THIS PLOT PLAN
1 i l` SHALL NOT BE USED FOR TITLE PURPOSES.
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��4 // G6c 0,4-43 SCHIyv9,p9�
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o Lot 10 ���, / / ' i�'�,1:.;;
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�`� JOHN SCHNURR, N.Y.S.,L.S. N0. 49517
F HOWARD W. YOUNG, N.Y.S.,LS. NO. 45893 �('f `'
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ti�6� �`�� q, + PLOT PLAN •
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40 44,
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F V b' LOT 10 SU'VMIT ESTATES SECTION 1
�� 5�}� .tip' '�*Cb• '' b.. - At East ' orlon, Town• of Southold s
ti - A�go \,%�`� Suffc k County, New York '�
S T- �#� `., Cr.0 °'\ 4 0,, County Tax Map District 1000 Section 35 Block 8 �` 5.11
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94 5 �0 9� A341.'
,�P �,P BUILDING FERMIT PLOT PLAN K
otp -1;1 �� 0 F �� /��\ -fi
0
c�� APR. 10, 20(
.X2.83, / \v LOt 7 AMENDED BUILDING PERMIT DATA JAN. 29, 19!
r( R / MAP PREPARED
' �- X0.00' (Vacant) •
me
" = 40'
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SCALE
NO. 199-0051
DWG. NO. 990051