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Bauer, Art
'�•• ilii JUDITH T.TERRY ,�I Town Hall,53095 Main Road TOWN CLERK t4 Z P.O.Box 1179 rft Southold,New York 11971 REGISTRAR OF VITAL STATISTICS 1 Fax(516)765-1823 RECORDS MANAGEMENT OFFICER MARRIAGE OFFICER �y?J� NV'O. Fax (516)765-1800 1 �` �� FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 1305 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : ART BAUER Address 1 : P. O. BOX 404 City St Zip SHOREHAM NY 11786 Descripton of Proposed Construction or Alteration SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING. APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES. SCHD REF. #R10-94-0043 Name Of Owner SAA Mailing Address 1 City St Zip 0000 Property Address 1 MILL LANE City St Zip MATTITUCK NY 11952 Tax Map No. section 107.00 block 4 lot 2.008 Cross Street WICKHAM AVENUE Building Permit Number Cross Reference: Issue Date: 4/07/95 Judith T. Terry Southold Town Clerk (TOWN SEAL) /3 ') JUDITH T. TERRY :, , ` ; Town Hall, 53095 Main Road TOWN CLERK : v P.O.nZ+ : Box 1179 cl'� � Southold, New York 11971 REGISTRAR OF VITAL STATISTICS Fax�. �� Fax (516) 765-1823 MARRIAGE OFFICER ,�j� �O �'� Telephone (516) 765-1801 RECORDS MANAGEMENT OFFICER -.. ,j l � ,P.� FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLDE MAR 3 ,n ' TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: March 22, 1995 Transmitted herewith is a copy of application No. 1353 for a Cesspool/ Septic Tank Construction Permit submitted by: Art Bauer • 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 C� DISAPPROVE p , Comments: e L,— Pi 11 cTC/4 �� X7f/ /t —'W—e,O 9.3 • Signature Dated //s— OFFICE OF THE TOWN CLERK "' "'% Town of Southold .�` �c i hill.` +, Judith T. Terry, Town Clerk ` � 0 '; Application No. / 3 5-3Town Hall, 53095 Main Road G ` Construction V- P. O. Box 1179 a • . Alteration Southold, New York 11971 � Telephone leo ! �Q��' $10.00 - Residential ✓ (51.6) 765-1801 _d' ®1 It�►n' ! $25.00 -Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. • Fee '$ DATE APPLICANT NAME: /q eT A lJl=f APPLICANT ADDRESS: ?O '©x L1 O 4- 51�c Th \W\ 1\-)kITL SEPTIC CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION \)f\ Tc`11\c V\ 47. 'L C / h1 LOCATION MAP: ' Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: S lal� OWNER MAILING ADDRESS: ' 11 .11-\ OWNER PROPERTY ADDRESS: \U1\ L L Lc\ YY)(Arj 'uc N 5 � TELEPHONE NUMBER OF CONTACT PERSON: 3t}- 01 z TAX MAP NO. : Section \ Block (4 Lot CROSS STREET: t/U CK\AAvr, BUILDING PERMIT NUMBER CROSS REFERENCE: 160' igna re of Applicant RECEIVED BY: Q Town yerk's Office DATE: / . (�� .c "iJ• i�ttt.i 6, ,1 ?,4 IP' e • o MAY 6 1994 �.°' \ ve Young & Young, Land Suryor's ! • 5 OZ v' °Ta 9y� 400 Ostrander Avenue, Riverhead, New York 1190P VOUtte _. 9c)• \50• �� \ / 516-727-2303 ,- �. r .n �l O oQ� a' ‘1,-,-,'..L! . `- pQ/7 h a-1 \\ / Vining Qa/��g� A \ /+�y� Alden W. Young, Professional Engineer Land Surveyor \_ h t� Howard W. Young, Land Surveyor / li t!" 11 $ fpr Q lose Thomas C. Wolper#, Professional Engineer ( •fit J i ,_ \ ri.ci.s�E 26e Kenneth F. Abruszo. Land Surveyor ` � o\\ / / \ s G ,26 `1 Px9_- t•�'`4'MIC.T�+a�i�'. ' i r QOg�O _____.,\''\\ ...„..1V �A7'?Z'y9� ��\ �FFOLK COUNTY yDEPARTMEN7: F £ - p�Pa� to�eo'`, j�o � �� 2$ a9 pR°� "\ pQ Det \.\ pPlt WAL OF CONSTRUCTION/�OMQL/Y�� /f / 6A5 O a0J h `I OO \ �R Z / / REF. N• ,/V /7 �(.' Y \‘') 5 i.1/147\/ 0'� 0 72 N OA / 11117,�� . ' \ . .1- iiPPIOVED N' 9 O� �j O F �'L o,. �,/1�_Q ,�[' Ngo .'0 0� 70 -� j SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES CERTIFICATION F e ::,,,j 0 " /�"P��,.S/��'ip r`�• / `�' �, 4 AM aIUAR DISPOSALSYSTEMSOR Fw�APPRO CFL S AND iLL�A�OE CONSTRUCTION / °2y P �,� .{' Ea W �" SI �� C� SET FORTH THEREIN AND • THE .-I• TO •.,'I^ T.- S 9 3°°; t< Off' of / APPLICANTS SIGNATURE �P►N .i 90 e3/. ���• Q�'i I (-�03/ �!I I APPLICANT: A�v4 oke_ c'1I-��V P/� ,��o `Y G Vf- �f = • / L A W. N 6�/% / �' c STREET ADDRES,S::�,�`� -)1C J '� C I et to P r q/ • 2 • 6 �, • �' ,•� VtOAO CITY: �(• \C YENm STATE �1� ZIP CODE: I I vb B28<: �_260.93 0 (J — V • ONENUMBER: �p 1j�yTUNDARTHUR G. BAUER 8 LAURETTA J. BAUER t o coNsiauctwNt 4 �S Op\\._\ '.� c``�A,cc( , Q\ LOT NO. 9, " WOLF PIT POND ESTATES" TEST HOLE Lot I 0 Y X96.> .` Y DARK O0. ^/ / Q CJ At: MATTITUCK Town of: SOUTHOLD } BROWNLOAM10• I 1 a o 3- / Suffolk County, New York O SANDY LOAM - Zo ^ _� 1 __ _ Il VALE N v Suff. Co. Tax Map: 11000 i 107 4 L 2 8 C BROWN FINE OSI I-r� O) Q District Section Block Lot TO O In (n ._ _ ___ 1 COARSE R•, O DWELLING Cy CERTIFIED TO: *. C -3,>,..v,9. Z o �'A'09 v Cf A'�• LAURETTA J.G. BAUER NOTE: „4 \., I. A r STAKE SET IN NORTH FORK BANK 8 TRUST COMPANY I '70' LOt 12 2. • = MONUMENT FOUND c . • r COMMONWEALTH LAND TITLE INSURANCE COMPANY ii * 3. SUBDIVISION MAP FILED IN THE OFFICE �" 4, t II OF THE CLERK OF SUFFOLK COUNTY ON7. JUNE 6,1990 AS FILE NO 8963 1 I T( 4. ELEVATIONS SHOWN HEREON WERE " / '/ %, i a APPROXIMATED FROM TOPOGRAPHICAL I..., 9 t �g ' DATE :MAY 3, 1994 1 cr., MAPS PREPARED BY OTHERS AND ARE " SCALE :1"= 100 o REFERENCED TO MEAN SEA LEVEL DATUM. O • .1k I ' SJOB NO. :94—0209 j O� LOt 11 SHEET N0. :1 OF 1 •