HomeMy WebLinkAboutTardif 000,11.1,sv F014-07;
JUDITH T.TERRY ; i', "izegt Town Hall,53095 Main Road
TOWN CLERK Pyr f; g P.O.Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS •
�+ �1 Fax(516)765-1823
MARRIAGE OFFICER ��`��0 Telephone(516)765 1800
RECORDS MANAGEMENT OFFICER V�o
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. 1345 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JOHN TARDIF
Address 1 : 116 BAY DRIVE SOUTH
City St Zip BABYLON NY 11702
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. #R10-95-0063
Name Of Owner TARDIF, JOHN
Mailing Address 1 116 BAY DRIVE SOUTH
City St Zip BABYLON NY 11702
Property Address 1 ROW OFF EUGENE ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 97.00 block 3 lot 18.009
Cross Street BAY AVENUE
Building Permit Number Cross Reference:
Issue Date: 6/15/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK • ® nz+ P.O. Box 1179
ifs Southold, New York 11971
REGISTRAR OF VITAL STATISTICS •
® Fax (516) 765-1823
MARRIAGE OFFICER =___ 41 �' Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER 1 �
FREEDOM OF INFORMATION OFFICER +� ��1�s���
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OFFICE OF THE TOWN CLERK ti r---____=„70
t
TOWN OF SOUTHOLD i!n
JUN - 7 1995
TO: Southold Town Building Department I `< t
To v^.`,li
FROM: Linda J. Cooper, Southold Town Clerk's Office - .11. 1D
DATED: June 7, 1995
Transmitted herewith is a copy of application No. 1396 for a Cesspool/
Septic Tank Construction Permit submitted by:
John Tardif •
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.
K?4L61:41 ee' 1614/c)
Linda J. Cooper
* * * * * * * * * * * *
I
have reviewed the application and location map of the project cited above
and make the following rrecommendations:
APPROVE v
DISAPPROVE
Comments: I „!- t j %) ' , a err,e
111,
Signatur-
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Dated
%- IEa
OFFICE OF THE TOWN CLERK ,,,,,,,,•'
Town of Southold 01' V0LA1,,&
�'J -, !t Application No./ 9
Judith T. Terry, Town Clerk ,�'
Town Hall, 53095 Main Road �� �.` � j°
Construction 1�
P. 0. Box 1179 ; =o rn
Southold, New York 11971 • ctl tic ; • .11
Alteration
Telephone _0•� ����• $10.00 - Residential
(516) 765-1801 =�'t �, ' $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 j � - 9
APPLICANT NAME: 'J 0Ji`vv `-0 F
APPLICANT ADDRESS: //b ��� ' 1)Pj1/e 500 )
>/:40 N. V /I7o
SEPTIC CESSPOOL •
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
A)E J ((-a pJ S�` R.t C 7`/.0,cJ
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 01/1/1,1—R--
OWNER MAILING ADDRESS: (*Nora_
OWNER PROPERTY ADDRESS:
(:) U TC ht06,o
TELEPHONE NUMBER OF CONTACT PERSON: 41 7/ •- c' , �
oq
TAX MAP NO. : Section 09 Block e-0 Lot 4497^
CROSS STREET: FJG 0441---
BUILDING PERMIT NUMBER CROSS REFERENCE:
If
Sign-Tot Applic
RECEIVED BY: /jilt:.
Town Clerk's Of ice
DATE: 0/7/1"---
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SURVEYED FOR: JOHN JOSEPH TARDIF & SHELLY E. TARDIF
PROPERTY LOCATED AT EAST CUTCHOGUE
- LOT No. 4
MAP OF FRANCIS GREENBERGER
FILED: APRIL 30. 1993: FILE No. 9350
TOWN OF SOUTHOLD
SUFFOLK COUNTY. NEW YORK
S.C.T.M. a 1000-097-03-18.009
AREA = 149.750 SF. = 3.438 ACRES
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COUNTY DEPARTMENT OF HEALTH SERVICES 2 re
APPROVAL OF N''•TilUCT!ON OF .
: -:74',10 i 4::,i•:R,E r ONLY '\c.si
:
'JAY 11 1995 r.'rs_rND. '/a-9 -00 k4
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A
11fil_E YEARS FROM DATE APPROV '