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Home My WebLink AboutGladitsch, William SOF F01 ELIZABETH A. NEVILLE _� 7� Town Hall, 53095 Main Road TOWN CLERK y P.O. Box 1179 REGISTRAR OF VITAL STATISTICS �y • �� Southold, New York 11971 MARRIAGE OFFICER O Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER ��( �� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 3135 R Residential x Non-Residential Fee $ 10.00 Septic x cesspool PERMIT ISSUED TO: Name : WILLIAM GLADITSCH Address 1: 3664 COLLECTOR LANE City St zip BETHPAGE NY 11714 Descripton of Proposed construction or Alteration SANITARY SYSTEM FOR ONE FAMILY DWELLING. APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES. REF #R10-02-0181 Name Of Owner GLADITSCH, WILLIAM ------------------------------ Mailing Address 1 3664 COLLECTOR LANE ------------------------------ ------------------------------ City St zip BETHPAGE NY 11714 -------------------- -- ---------- Property Address 1 550 BAILEY BEACH ROAD ------------------------------ ------------------------------ City St zip MATTITUCK NY 11952 -------------------- -- ---------- Tax Map NO. section 99.00 block 3 lot 4.013 ------ --- ------ Cross Street SOUNDVIEW AVENUE ------------------------------ Building Permit Number Cross Reference: ---------------------------------- Issue Date: 1/29/04 Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) ELIZABETH A.NEVILLE G'�� Town Hall, 53095 Main Road TOWN CLERK ti P.O. Box 1179 REGISTRAR OF VITAL STATISTICS %Ismo Southold,New York 11971 MARRIAGE OFFICER y O!� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER �Ol �a Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net JN 6 2W4 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: January 6, 2004 Transmitted herewith is a copy of application No. 3272 for a Cesspool/Septic Tank Construction Permit submitted by: William Gladitsch-Catherine Mesiano as Agent 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 loc ion map of the project cited above and make the following recommendations: APPROVE DISAPPROVE Comments: Signat e / �v ted ELIZABETH A.NEVILLE h`Z` �G.y Town Hall, 53095 Main Road TOWN CLERK co P.O. Box 1179 C4 Southold, New York 11971 REGISTRAR OF VITAL STATISTICS v. MARRIAGE OFFICER Gy • �`F Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER �f Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER 0'� �a southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential @ $10_ or Non-Residential @ $25 Application No. Permit No. Applicant Name eqdL4rr –� � – Applicant Mailing Address 1171 L Septic Tank ---or Cesspool Brief Description of Proposed Construction or Alteration—n etA.-) d..e�,4_ Location of Proposed Co t etion/Alteration: - Owner of Property: Owner Mailing Address:_ 11-7 g Owner Property Address: 5 Name and phone number of contact person J-1 m Tax Map No: /0 0() Section Block 3 Lot Cross Street NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SU 77= MENT APPROVAL l 6 g' S'gn ture of Applicant ate Received by: b 1� P�eo p' d p Foos E 'ese 8�p"E N6g� ' `\ N N5 3 0 1.900. eo y\ ` ea P� , ��5° \ \ o EXCAVATION INSPECTION REClt1lRED FOR SANITARY SYSTEM €.YH-"- na t 3'^psi H \ SUFFOI.I�COi1N'iRfSsS193�Y:tl_L 000001, TF OFIAI.THSERVICE OONLV DAA - RE .�'�3 �0 2- a t�r J r a ,�$�o"w O P APPROVED FOR Oc - F:O UG1VfS -� � P WJE EXPIRES 1111-CE YEARS FROM DA'Z'E OF OVAL, �FZ� Survey for: 7 WILLIAM CLADI T 'COUNTY Lot 13, "Honeysuckll, HOTN _' AM 0 � At 06 Mattituck t3FiCE WASTEWATRVMM Town of Southold Suffolk County, New York S.C.T.M.: 1000-099.00-03.00-004.013 30 0 30 I I I I SCALE:1"=30' 0\. 1 NOTES: l0 �`1 O 1. AREA = 25,000 S.F. 2. ■ = MONUMENT FOUND, A = STAKEFOUND. Z 3. SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK SaN�j M Q OF SUFFOLK COUNTY ON OCT. 16, 1981 AS FILE NO. 7019. Z C DATE: SEPT. 05, 2002 JOB NO:2002-441 8 CERTIFIED TO: WILLIAM GLADITSCH S6g,a 3� DAVID H. FOX N.Y.S.L.S. #50234 FOX LAND SURVEYING PO BOX 224 SPEONK, N.Y. 11972 (631) 325-2902 UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OFSECT10N 7205 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. CERTIFICATION INDICATED HEREONSHALL RLIN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON , AND TO THE ASSIGNEES OF THE LENDING INSTITUTION. CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS. DWG: 2002-441