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HomeMy WebLinkAboutBacher, Jason Are ELIZABETH A. NEVILLE ,t° `Z4 Hyl`;Town Hall, 53095 Main Road TOWN CLERK p _ , P.O. Box 1179 REGISTRAR OF VITAL STATISTICS �y Southold, New York 11971 • MARRIAGE OFFICER � Fax (516) 765-6145 � RECORDS MANAGEMENT OFFICER `. O ���•1, Telephone (516) 765-1800 FREEDOM OF INFORMATION OFFICER '� l 11•' OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 2133 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : JASON BACHER Address 1 : 48 MAGNOLIA LANE City St Zip ROSLYN HEIGHTS NY 11577 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 #R10-99-0143 Name Of Owner BACHER, JASON -CONTRACT VENDEE Mailing Address 1 48 MAGNOLIA LANE City St Zip ROSLYN HEIGHTS NY 11577 Property Address 1 CLIPPER DRIVE City St Zip SOUTHOLD NY 11971 Tax Map No. section 79.00 block 14 lot 17.003 Cross Street ANCHOR DRIVE Building Permit Number Cross Reference: Issue Date: 8/16/99 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) 2 / 3 • • �o leo, ufFO1,,0 ELIZABETH A.NEVILLE , `Z`�� �*IN Town Hall, 53095 Main Road TOWN CLERK p _ P.O. Box 1179 1 Z Southold, New York 11971 REGISTRAR,OF VITAL STATISTICS v. t' Fax (516) 765-6145•MARRIAGE OFFICER L RECORDS MANAGEMENT OFFICER O�'�� Telephone (516) 765-1800 FREEDOM OF INFORMATION OFFICER . O/ jig4. 0 Ar. OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: August 10, 1999 Transmitted herewith is a copy of application No. 2219 for a Cesspool/ Septic Tank Construction Permit submitted by: Jason Bacher 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: ignature Dated Mir OFFICE OF THE TOWN CLERK l'",S�`I etke "_ ^1 / TOWN OFSOUTHOLD �;'`Q �l CD*4\ = Application No.av--+ ELIZABETH A.NEVILLE,TOWN CLERK v P.O.BOX 1179 Construction SOUTHOID,NEWYORK11971 Alteration p� Telephone y�ij' Qri $10.00 - Residential (516) 765-1801 ----- — 1„�•�'', $25.00 -Non-Residential • - >,'' TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee $ II DATE 8/ ,l a 5 APPLICANT NAME: - As0A) -- 11 APPLICANT ADDRESS: 1-16 MAGAJD/1 'f LA , oslyi/tr i1Gis, 41. / I-77 SEPTIC CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION 90O Ct,41._ x.10`Tl G i k- w LT 4 ' 'lt_'x 8 1-1z-"-e a)s)4 2.0.3c...1 4 D.DA\.� P c 1--- LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: •fao.�TI�'ocB` i' � l� OWNER OF PROPERTY: ..155_.. 0),i 1,gGIAii1> cow-MALT Vii.AmNk-1L OWNER MAILING ADDRESS: 113 )\' 4L.44 L-A . 1Z.,: G-) lt.,,t+TS S l.i'? )1 S 7.) OWNER PROPERTY ADDRESS: TELEPHONE NUMBER OF CONTACT PERSON: S'/C=> -�z 1 -776Del TAX MAP NO. : Section cy-- q Block g Lot 17. CROSS STREET: ASV Q l\-Q o L bGZ , BUILDING PERMIT NUMBER CROSS REFERENCE: c�� Sign e of Applicant RECEIVED BY: E5 �-�` Town/ DATE: ]� 6 I( 1 //' SU/2VEY OF LoT 79 AN HOR LANE. oma/ MAP OF- 0 F �,. HAR8012 L/6HT.� ESTATES, SECTioN Fou�e A MAP No. 7703 9 AT SOUTHOLD Z1,? v TOWS/ OF 50 UTHOLD , d ) aN N SUFFOLK COUti/Ty, NY r. J ') „ "oc1Yw � 7 /000 -79 04- /7. 3 7 ^ :- v .;. S.6 '05' O"L. 2/5.00 r, _:•,,.,�.. W J Q +o f 1 s..is'=, .�.x cerz„:Q s i c_.r.�,Jt)yg�l73EPAfi. {,.t!/ 'ANT OF}I {L 3EF;VI�?,q I J I- io• 104.2 j 106.7 �._ T�^j��;�6�?!f•t rts �� F‘I O , 7 `L-.�`�I .,. , ..� lO PYA ,°0\ , 0 +. ---. N i 1:,-::2O v : RSYEA p © 8 " FFROM DA i G OF APPROVAL o N VI. • l\''ll' V .3c ;'it„,...-0)_. t AP_ N H ..r o r wb� s.-vj 2 + 5ET2,Ac a 1- t ro fr a a 1 0 a m A gl V .�° ., _ __ I 4 i &‘i \( F_„5.1., y1 n 15 o n, try 1..) ! It /Si litparti ��ob s y, � 0 d Q /; 9 _ �P�,OF NEw y� a I� ti ) 11111h1, r (� art -'��Q'' you I 0-,,. � Q '- 4. tr i` n.a NOTE: F 1 NO.049' �4' :•/ F...Ds. PR DP _ N. 33 0o"�c% r,a „� k TEST HALE 1NFp. - t. ��S a s" /72.5 F"� \ SEE FILED MAP �w .o, Co N LI W �� _.�...,,,..�,�.. �. ., �.. LISA IVIcQUILKI/V s• 4� +- .� ur+a.w+ww.+.r�"wr..r�. LAND SURVEY/NG �+ U v • ,. 1_- TT tib. / . .,'.Ms *�r! ti1wM• . :/ • 54 SECOND ST. .o �a b`. , ��''� "'�► K!. SAYVILLE, NV 117% • n �M 5ico - 563-4952 .104 1830 ..enort-•wa ad,'r w��1C. 1�M�' ' 0�uQ � _ �,.. - � �:•�.�.. 4 SCALE: l' A-40' ,l� o DATE: ✓UME /B, /999 l r` Job No Q6,oa-99