HomeMy WebLinkAboutBazata, Nadine ff'o00FFO�,�c
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JUDITH T.TERRY •� y1N Town Hall, 53095 Main Road
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TOWN CLERK ti Z P.O. Box 1179
1/, Southold,Sthold, New York 11971
REGISTRAR OF VITAL STATISTICS Oy� O� ,'', Fax(516) 765-1823
MARRIAGE OFFICER
MANAGEMENTRECORDS F INFORMATION OFFICER
�� Telephone (516) 765-1800
FREEDOM OF
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1716 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : NADINE BAZATA
Address 1 : 500 GROVE DRIVE
City St Zip SOUTHOLD NY 11971
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 #R10-97-0120
Name Of Owner BAZATA, NADINE
Mailing Address 1 500 GROVE DRIVE
City St Zip SOUTHOLD NY 11971
Property Address 1 9680 NORTH BAYVIEW ROAD
(LOT3 OF PELLICANO WOODS)
City St Zip SOUTHOLD NY 11971
Tax Map No. section 79.00 block 8 lot 13.000
Cross Street
Building Permit Number Cross Reference:
Issue Date: 8/25/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
•
JUDITH T.TERRY AF G'f �1 Town Hall, 53095 Main Road
TOWN CLERK ; y .r4 P.O. Box 1179
Pry � Southold, New York 11971
REGISTRAR OF VITAL STATISTICS O 1
MARRIAGE OFFICER �W •�
1 Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER = ,� � Telephone(516) 765-1800
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FREEDOM OF INFORMATION OFFICER 016��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: August 15, 1997
Transmitted herewith is a copy of application No. 1787 for a Cesspool/
Septic Tank Construction Permit submitted by:
Nadine Bazata
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:
gnatu
Dated
Ilk
OFFICE OF THE TOWN CLERK
Town of Southold orttt, Votkr„
�� 5 O : Application No. /7E5--7
Judith T . Terry, Town Clerk �� .; t•. G�
Town Hall, 53095 Main Road =► ....+tt. ; Construction
P. O. Box 1179 . =, •': • e,'. renAlteration
Southold, New York 1 1971 Lt %; '7.: 'r 0 --
et
$10.00 - Residential
Telephone
(516) 765-1801 ---.... 1/1 * � $25.00 - Non-Residential
. . .a
TOWN OF SOUTHOLD .
• SOUTIIOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT IC)N
for •
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
•
Permit No.
Fee $
DATE S - 2 - a7
APPLICANT NAME: 1\..11c,ne atz_A .
APPLICANT ADDRESS: 600 C rr.)ve )ri v e
Southold kt. y ( (171 •
SEPTIC CESSPOOL t/------
DESCRIPTION OF PROPOSED CONSTRUCTION—� iOR ALTERATION
1 WO J6r � in I �rm r1`-t r ?�U 5 e
LOCATION MAP: • Must be attached hereto before permit may be issued.
LOCATION OF PRQPOSED CONSTRUCTION OR ALTERATION :
OWNER OF PROPERTY ; RC18ine 6GZX '
OWNER MAILING ADDRESS: 500 C rov e ri ve
Sou+-holo i\LI 119-7 I
OWNER PROPERTY ADDRESS: (1(080 Nor-14) 36qVietA)--- 01 ,50041'10WN y (u -7i
TELEPHONE NUMBER OF CONTACT PERSON: 7(05 -- 1 q 62_
TAX MAP NO. : SectionI `7q Block 8 Lot ( .j
CROSS STREET : or-1-ht)i ei,o-ocA
BUILDING PERMIT NUMBER CROSSII REFERENCE:
i _
Signatur: of Applicant
i__A ;..
RECEIVED BY ; 44
Town Cleric's ffice .
DATE; '11.5 -Y7
888.96' TO Aj ��[[ Q A
4*- DRIVE D NORTH a Jahr' .SRW D •
SEAWOOD
• .—.- _
RIVET 'L1L .
DK BR 4 414•b
�— - --_— 1 .II 28 All :44 \ LOAM
11 BRONM
SANDY
LOAM
14
PALE
B ROWN
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TO
COARSE h
>-
SAND
N 3
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERV! N p PALE
B ROWN
FINE
FOR APPROVAL OF CONSTRUCTION ONLY Y- x-40 To
COARSE a
ri
DATE H.S. REF. NO. & SAND
IN
APPROVED N WATER
THE WATER SUPPLY AND SEWAGE DISPOSAL h) TEST HOLE DATA
SYSTEMS FOR THIS LOT SHALL CONFORM TO
THE STANDARDS OF THE SUFFOLK COUNTY \
DEPARTMENT OF HEALTH SERVICES
LOT No. 2
/S6 2' !" 18.3 ' — •
ON , — —
LOT No. 4
1 4 1 1 S67 52'50"E Q 0 ' GE`8,
r • Mo,pirsinlw
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illR- R00'
Pi 11 , L 36' 4'\\ MRNINNM IooOG ALLON SEPTK-
rte. PROP. TYYvK 1300 S.C. Fr OF PROP.
"`2't PROP. (7'� PROP. 9roEwAu LPA
37 L.P. • I OLP. LEACIi/NG •
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IS
v ROP. 1 P PROP.
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! M %VIIrr At). \ i-
vF`+ ' 00' 6�'• A. •- \ •
\ gy I PROPOSED \ ,e!"
i iOS DWELLING S
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4
CER 1 7 1E1 TOS ! g
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O , PROP.
NEIL C7
QQ 1.••,-.
N 1 N
THE EXISTENCE OF RIGHTS OF WAY Z \ UT
AND/OR EASEMENTS OF RECORD IF \
ANY, NOT SHOWN ARE NOT
GUARANTEED. \
LOT No. 3
UNAUTHORIZED ALTERATION OR ADDITION 2.40 ACRES N.
TO RES SURVEY IS A KOLA AON OF
SECTION 7209 OF THE NEW YORK STATE N.
EDUCATION LAW N
COPIES OF THIS SURVEY MAP NOT BEARING
THE LAND SURVEYORS INKED SEAL OR \
EMBOSSED SEAL SHALL NOT BE CONSIDERED — --‘,—
TD BE A VALID TRUE COPY. N6916`50"W 265.10' \
GUARANTEES INDICATED HEREON SINALL RUN
ONLY TO THE PERSON FOR SHOO THE SURVEY
IS PREPARED, AND ON 1,75BEH TD THE LAND N/F AKSCIN
17TLE CCNRPANY, GOVERNMENTAL A CY AND
LENDING RNSTTTURON LISTED AND
TO THE ASSIGNEES OF THE LENDING,INSTT-
TUTlO4 GUARANTEES ARE NOT TRANSFERABLE.
SURVEY OF: DESCRIBED PROPERTY
ALSO KNOWN AS LOT No. 3 ON MINOR _ KENNETH H. BECKMAN. L.S.
SUBDIVISION OF "PELLICANO WOODS"
Surveying and Land Planning
SITUATED IN: BAYVIEW
5018 Expreeeway Drive South
TOWN OF: SOU7HOL0 Suite 202
Ronkonkoma. N.Y. 11779
SUFFOLK COUNTY. NEW YORK ,,'"ii1 E- _ 588-0380
lc,t0 N.ec1/2.-4,013\fr- e1e 4e7-2941
• DATE: 4/7/97 JOB NO. 87-2737 SCALE: 1" - .. la .
11`'‘I
DIST. SEC. BLK. LOT :* x;�, *. AUG 0 119 •
97
S.C.T.M. NO. 1000 079 08 P/0 13 =,r '`p""- oa: WPLa '
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LAND