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Home My WebLink AboutBouser, Frederick 4\ Ciji, Cy, I Lit , r�p rt CG'. s vim" r, ' k Town Hall, 53095 Main Road P.O. Box 1 17 9 ��` e`.i N.t�f- Southold, New York 11971 JUDITH T. TERRY .•..4. , TEL!{PIiON1: TOWN CLERK (516)765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD June 23, 1987 Frederick A. Bouser 78-21 73rd Place Glendale, New York 11385 Re: 450 Indian Neck Lane Peconic, New York Enclosed herewith is the Construction, Alteration or Modification Permit for a Septic Tank or Cesspool System for which you applied. Please be advised that each owner of real property operating an on-site sewage disposal system, such as a septic tank or cesspool must, prior to such operation, possess in the name of the owner an Operation Permit for the system. The Operation Permit is issued by the Town Clerk's Office. The fee for an Operation Permit is ten dollars ($10.00) for residential use and twenty-five dollars ($25.00) for non-residential. Please have the owner complete the enclosed Application for an Operation Permit and return it to this office along with the proper fee. For your general information I have enclosed an Informational Bulletin regarding the Scavenger Waste Laws adopted by the Southold Town Board. Should you have any questions pertaining to either permits or the Scavenger Waste Laws, please do not hesitate to contact this office. We will be glad to assist you in any way possible. Very truly yours, Or4114444004":"Ze.:#41111.1" 1. Judith T. Terry Southold Town Clerk Enclosures (3) JTT/Ijc • OFFICE OF THE TOWN CLERK c,OFO(Ar�;" Town of Southold Olj Judith T. Terry, Town Clerk Town Hall, 53095 Main Road P. O. Box 1179 cn Southold, New York 11971 "(jfi e.Off- Telephone - �l i (516) 765-1801 ' TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 185 Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: NAME: Frederick A. Bouser ADDRESS: 78-21 73rd Place Glendale, New York 11385 DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION New Single Family Dwelling with Sanitary System APPROVED as submitted LOCATION OF PROPOSED CONSTRUCTION or ALTERATION: OWNER OF PROPERTY: Frederick Bouser and Bernardine Naughton OWNER MAILING ADDRESS: 87-21 73rd Place Glendale, New York 11385 OWNER PROPERTY ADDRESS : 450 Indian Neck Lane.:, Peconic, New York TAX MAP NO. : Section 86 Block 4 Lot 1 .7 CROSS STREET: BUILDING PERMIT NUMBER CROSS REFERENCE: Judith T. Terr Southold Town Clerk DATE: June 23, 1987 (TOWN SEAL) v . 1 ,S ii-,i' OFFICE OF THE TOWN CLERK c3IFOC,j Town of Southold ��0JCD4 ; Application No. /� ' Judith T. Terry, Ton Clerk erk ..� J Town Hall, 53095 Main Roadts) m Construction P. O. Box 1179 ".�J Alteration Southold, New York 1197151/ 'To,. 0�- Telephone _0! 4t ��; 1' Residential (516) 765-1801 Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. /f-.6.--/ • Fee $ d DATE j-u Y,e- /G/ /li 7 APPLICANT NAME: yr•fc/ e,-,'c/\ A 0 bier APPLICANT ADDRESS: `7&-v2 / 73 y2/4 ( V—1 to rrcla/V, Ay y //c! O- SEPT I C —CESSPOOL DESCRIPTION. OF PROPOSED CONSTRUCTION OR ALTERATION 0,7t ;TA �/ Q'c' e//,-; y � LOCATION MAP: Must be attached hereto before permit may be issued. • LOCATION OF PROPOSED /CONSTRUCTION. OR ALTERATION: OWNER OF PROPERTY: /r�"cc/Pr, c/t J1- (} c/a/A,'" �Xie"''`a� - �' /froty fr OWNER MAILING ADDRESS: •Jg-?// 73,2%( Uleno a'/ Ny //aoi - OWNER PROPERTY ADDRESS: Vt d `li,ic/.6 , nc-4 4,, ‘<' • > �7-,. <-0,-.,/‹ . /19u--- . TELEPHONE NUMBER OF CONTACT PERSON: 7/r Yu- G- O4'35 cy TAX MAP NO. : Section g-t, Block 'y Lot / 7 CROSS STREET: P"?U /. BUILDING PERMIT NUMBER CROSS REFERENCE: 0741 Signature of Applicant RECEIVED BY: ( ftiK-az,-,,i, ii -,-J Town Oerk's fice DATE: 6 - /(p- S-7 • 1P FOLK CO. HEALTH DEPT, A OVAL k y �+ i� S. NO. t, LOQ` `*5, 1 1 tcc-.r ' O MhR OF O, NJ C c 4/ ';F'1 L_? 1 t`4 ., # „E12-14'S 1*F'�t 'E dpi 71559. / M""f x x' nK LEVEL «•�..�....r�. ...... +�,.4Y..r...-...i" n._..... .+.,. A t \\./ , �ti © ' TA KW. STATEMENT OF INTENT k t ( , r... +, �^ y / w'E . THE WATER SUPPLY AND SEWAGE DISPOSAL ' . 4 2 /, SYSTEMS FOR THIS RESIDENCE WILL L_.__ / CONFORM TO THE STANDARDS OF THE , :: I.: ,� Bar P j tsi ! -1•"" * ! '�r 0PPLICANT �� i / i + / ` SUFFOLK COUNTY DEPT. OF HEALTH :' f G SER VICES — FOR APPROVAL OF _. _ , `� r CONSTRUCTION ONLY 10 / DATE: S. H. S.REF. NO.. t 4o a'' ws` /' N , _ SUFFOLK CO. TAX MAP DESIGNATION C) ' k.` At►ifi ° DIST. SECT. 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