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Home My WebLink AboutBauman, Bonnie M ir • �,°,osuFFot,��o ELIZABETH A.NEVILLE _� Gy�: Town Hall, 53095 Main Road TOWN CLERK ; y •Z P.O. Box 1179 v. REGISTRAR OF VITAL STATISTICS k164#, `F�� MARRIAGE OFFICER =�_y� Southold, New York 11971 v Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER �� Vo,.��ll� 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. 3151 R Residential X Non-Residential Free $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : MORRIS CESSPOOL Address 1: 2760 YENNECOTT DRIVE City St Zip SOUTHOLD NY 11971 Descripton of Proposed Construction or Alteration ADDITION TO EXISTING SYSTEM. APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS, EUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION INSPECTINO REQUIRED. Name Of Owner BAUMAN, BONNIE Mailing Address 1 1065 HYATT ROAD City St Zip SOUTHOLD NY 11971 Property Address 1 2070 HYATT ROAD City St Zip SOUTHOLD NY 11971 Tax Map No. section 50.00 block 1 lot 1.000 Cross Street Building Permit Number Cross Reference: Issue Date: 4/15/04 Elizabeth A. Neville Southold Town Clerk (TowN SEAL) h ELIZABETH A. NEVILi.F, ; h`Z 'f� TOWN CLERK § Town Hall, 53095 Main Road P.O. Box 1179 REGISTRAR OF VITAL STATISTICSr Southold, New York 11971 MARRIAGE OFFICER �� ifi ��I+, Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER = �l �a�,'�� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER - southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: March 12, 2004 Transmitted herewith is a copy of application No. 3290 for a Cesspool/Septic Tank ALTERATION Permit submitted by: Morris Cesspool for Bonnie Bauman 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: Maintain required setbacks from adjacent wells,buildings,property lines and water Bodies. EXCAVATION INSPECTION REQUIRED. ignature (2-i A0d Dated E off sUFFO4 osO p ELIZABETH A.NEVILLE Ish`L` 4\ Town Hall,53095 Main Road TOWN CLERK : 1P.O. Box 1179 Ne REGISTRAR OF VITAL STATISTICS %v, ; Southold, New York 11971 MARRIAGE OFFICER '� 1� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER '' V/ 0.•i Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER ilb -... * , ,'i 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.3;00 7172ef. . Permit No. Applicant Name �i s� ( zPe Applicant Mailing Address 17,6 Oa-fr/PEGot r e)/e . Septic Tank or Cesspool—! Brief Description of Proposed Construction or Alteration Location of Proposed Construction/Alteration: Owner of Property: A401/.6- L/¢t, m,1" Owner Mailing Address: 1 G(oS 1-� A/yr TT 4eP 16 ( <- 'IGCQI) Owner Property Address: 0110 . 0,j.,06eizt Name and phone number of contact person 1C3 Y3" Tax Map No: Section .5-0 Block 1 Lot Cross Street NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL ug ti 1, Aept.47 ocl Signature of Applicant Date Received by: 1-011-1 �o"-- iveil E`''on 13r a