HomeMy WebLinkAboutGatz, Walter & Marilyn (2) ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
/~L-kRRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORI~L~TION OFFICER
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax ~6313 765-6145
Telephone (63D 765-1800
sour holdtown.nor thfork.net
TO:
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Southold Town Building Department
FROM: Lb/da J. Cooper, Southold Town Clerk's Office
DATED: October 28, 2004
Transmitted herewith is a cop.',' of application No. 3390
Permit submitted by:
for a Cesspool, Septic Tank Construction
Waller & Marllvn Gatz
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:
Signature
Dated
I~LIZABETH A. NEVILLE
TOVVN CLERK
IIEGISTILAR OF VITAL STATISTICS
i~L&RR IAGE OFFICER
RECORDS NL&NAGEMENT OFFICER
FREEDOM (;IF INFORAIAT10N OFFICER
Town ilall, 53095 IMam Road
P.O. Box 1179
Southold. New York [1971
Fax ~.a3D 765-6145
Telephone i631 ! 7(55- 1800
southoldtown.n~x t ht'~,rk.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTIIOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION ~/~
CONSTRUCTION or ALTEILiTION PERMI[T
CESSPOOL or SEPTIC TANK
Residential(~.,Sl0____ or Non-Residential(5~$25 )~
Applicant Name Wal~er Gatz and Marilyn Ga~z
Applicant Mailing Address P.O. Box 45, Mattituck, ~'
Application No. ~,~D
Pemlit No.
11952
Septic Tank x or Cesspool x
Brief Description of Proposed Constructioi~ or Alteration
and storage building
Construct agricultural barn
Location of Proposed Constructiol~/Alteration:
Owner of Property: Walter Gatz and Marilyn Gatz
Owner MailingAddress: P.O. Box 45, Mattituck, NY
11952
Owner Property Address:
Sound Ave., Mattituck, NY 11952
Name and phone number of contact person. Walter Ga~z or Marilyn Gatz
Tax Map No: Section 121 Block O1 Lot 4is~oa~.d7
Cross Street_ Cox Neck Road
NOTE: LOCATION IM[AP MUST BE, SUBMEFTED WITIt APPLICATIONF---~W
CONSTRUCTION REQUIRES SURVE5 WITH ItE.,~TIt DEPAI~dl~IENT API~ROVAI.
Signature of Ath01icant / t~ate ~x:¢7'. ~
!~ / ! . Walter Gatz /~a~:ilyn Ga~z
2004
I~XF~AN.,GI ON
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6ose9~
ormOclu~ . ~olZ
h. OnU~ro'r"' '
'T~ST HOLE ~2ATA
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Young & Young
400 08trander Avenue, Rivewhead, New York llgOl
~3 I- 72?-2303
H~ard ~. Y~, La~ ~
Ro~ld ~. P~ L~oape dv~h~
WATER LINE(S) MUST BE INSPECTBD BY THE
SUFFOLK COUNTY DEPT. Of HEALTH SERVICES.
CALL 852-2097, 48 HOURS IN ADVANCE,
TO SCHEDULE INSPECTION(S).
ApprovaJ for Con~l;r,lclion. Othei, ~ 81n~i~ F~
supply and sewage disposal. Rega~ss of ~y omissions,
~sistencies or la~ o~ ~ ~ ~ ~ ~ ~ ~
51TE DATA
TOTAL A~A = 5.0041
· ZONIN~ ~E DIST~.IGT
· VE-~TIC. AL DATUM
= A ~ I C.4JL ~ -C4DN.GE~V'ATI ON
= N.~.V. DATUM (H.SJ.. I~'~)
~DIVI~ION "~,EI=N
EN~I NEEI~,'5 CEI~,TIFIGATION
~OUN~AT~ ~ONDITfON~, ALL LOTS, THE ~FFOLK ~Q~N~
~U~V~O~'~ ~TIFIGATION
· /
HOYtA~D d. ¥OUN¢ N.¥.5. L.5. NO. 45¢c~D
A'F'PLI CANT
~ALTF=~ 5ATZ