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OFFICE OF THE TOWN CLERKFO C�
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Town of Southold O�� =r_.
Judith T. Terry, Town Clerk % )00: �'
Town Hall, 53095 Main Road
P. 0. Box 1179 ',u-3 at t
Southold, New York 11971 0 � "
Telephone -SO •
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(516) 765-1801 '
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 206 Residential T x
Non-Residential
Fee $ 10.00
Septic Cesspool X
PERMIT ISSUED TO:
NAME: John Bertani Builder Inc.
ADDRESS: 1380 Oakwood Drive
Southold, New York 11971
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling with Sanitary System
APPROVED as per Suffolk County Health Dept. approval
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: Marisa and Ivan Toic
OWNER MAILING ADDRESS: 35-44 71st Street
Jackson Heights, New York 11372
OWNER PROPERTY ADDRESS : Budds Pond Lane
Southold, New York
TAX MAP NO. : Section 56 Block 5 Lot 6
CROSS STREET: Bay Home Road
BUILDING PERMIT NUMBER CROSS REFERENCE:
Judith T. Terry
Southold Town Clerk
DATE : July 29, 1987 -
(TOWN SEAL)
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Lg.' . , ` a�`;, S Town Hall 53095 Main Road
" "�► P.O. Box 1179
-7342.
ice Southold, New York 11971
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JUDITH T. TERRY '�4iiy"/N-°. TELEPHONE
TOWN CLERK (516) 765-18(11
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
July 29, 1987 -
John Bertani Builder Inc. •
1380 Oakwood Drive
Southold, New York 11971
Re: Marisa and Ivan Toic -
Budds 'Pond Lane
Southold, 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 ours,
Judith T. Terry
Southold Town Clerk
Enclosures (3)
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—� ` ��• �r Southold New York 11971
JUDITH T.TERRY - TELEPHONE
TOWN CLERK (516)765-1801
- REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK _
-- TOWN OF SOUTHOLD
:uly 27, 1987
To: • Victor Lessard, Southold Town Building Department
From: -Judith T. Terry, Southold Town Clerk -
Transmitted herewith is a copy of application No. 209 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by John Bertani Builder Inc. for Marisa & Ivan Toic-- . - - -
Please review the application and location map and advise if the
project has received Suffolk County Health Department approval __
and if we may issue the permit.
Please complete the form below and, return it to my office.
Thank you.
e;pr •
ee4ca
Judith T. Terry
Southold Town Clerk -
* * * * * * * * *
I have reviewed the application and location map of the project
cited above and make the following recommendation: --
APPROVE - D( _ _ -
DISAPPROVE -
COMMENTS: saga, _,...04.off' cQ,, !'r* 44 Na 409.A Nr.,
. QI4SL CLITL01041..
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Signature
Vayi II 7 -
Date
OFFICE OF THE TOWN CLERK
;Town of Southold
. Judith T: Terry, Town Clerk Application N . ' D
Town Hall, 53095 Main Road _ Construction
P. 0. Box 1179
Southold, New York 11971 Alteration
Telephone _ Residential
•
(516) 765-1001 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION .
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE •ry LY 7-5! / 587
APPLICANT NAME: �.1 a//,v E,2%�,c.l i Bug,40Ete z 'c,
APPLICANT ADDRESS: /38o 0s9ezotroo Z7/2
-SDo C r� j cls n ei
SEPTIC / CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ma,riscL.— a - Ole;
OWNER MAILING ADDRESS: 35-fit( 7/
H kl N y
OWNER PROPERTY ADDRESS: /Ju(r( i �✓c�/1 �� Lo-n
01� 0 1ciJ
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section 610 Block 0 6 Lot 06 •
CROSS STREET: aCui H %�e_� -J`-
BUILDING PERMIT NUMBER CROSS REFERENCE:
ignature of Applicant (2/1-Ld.
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RECEIVED BY: -44,: ,/ ��
To rk s •ffice —
DATE: ,,
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( VAC Propared to accordance with the minimum
a _ ANTS-- •inr;rdards for tide surveys as established by
�� — - ilio L.I.A.L.S. and approved and adopted
- for such use by The New York State Land
J/// lltle Association. _
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The water supply & sewage disposal sys-
' tems for this residence will conform to the
standards of the Suffolk County Depart-
_ ment of Health Services.
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20, LOT 4 v rvAc�n, rl
'U LOT 3 _ ��� J� r,.5,- , S-URVEY OF
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O MAP OFSUBDIVISON
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p0 10 ;V` - W FILED JUIN. 16,1966 NO.4652
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'"/ o AT .1 RSHAMOIOAQUE
\a of q _ F. TOWN OF SOUTHOLD
i cv ,VAC9 r) in SUFFOLK COUNTY N.Y.
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885- 8UDD'S POND RD.
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SINGLE -Y--- 1ELLtNG ONLY
LOT 17 - LOT 16 EXPIRES TWO YEARS FROM DATE OF APPROVAL
NT) 1 R r{
bW�-Lc,/IQ ,At/ie (,6-7 / M IHSPCERT1F1ED TO:
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VICTOR CAVALLI
SUFFOLK COUNTY DEPARTMENT OF,HEALTH SERVICES
..— •. FOR APPROVAL OF CONSTRUCTION ONLY
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54655 MAIN ROAD -)US, / J-g
, SOUTHOLD, N.Y. 11971 �S
87- 364