HomeMy WebLinkAboutGatz, Jeffrey JUDITH T. TERRY � �Q G.*4 Town Hall, 53095 Main Road
TOWN CLERK = Z P.O. Box 1179
REGISTRAR OF VITAL STATISTICS : G '74 Southold, New York 11971
MARRIAGE OFFICER � Fax (516) 765-1823
0� � Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 730 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : VINCENT R. BONTI, JR.
Address 1 : P. O. BOX 329
City St Zip MT. SINAI NY 11766
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 5/22/91 .
Name Of Owner GATZ, JEFFREY
Mailing Address 1 170 ASH STREET
City St Zip FLORAL PARK NY 11001
Property Address 1 BAILEY ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 99.00 block 3 lot 4.013
Cross Street SOUNDVIEW AVENUE
Building Permit Number Cross Reference:
Issue Date: 7/01/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
v,
. .g JUNI9 /99
Town Hall, 53095 Main Road r y P.O. Box 1 179
�l • , Southold, New York 11971
JUDITH T.TERRY - _: TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLDd
To: Southold Town Code Enforcement Officer
From: Linda Cooper, Southold Town Clerk's Office
Dated: June 19, 1991
Transmitted herewith is a copy of application No. 7118 for a Cesspool/
Septic Tank Construction Permit submitted by:
Vincent R. Bonti Jr. for Jeffrey Gatz
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 x
DISAPPROVE
Comments: qr Qa DNel o.C-Qy ,""L. "4-
J
Signature
la I a.dct
Dated
I,.
IIS-.
OFFICE OF THE TOWN CLERK (\COFJ(,'`;'
Judith T.
of So .,Town Clerk �. . •a �` O� Application No.
Terry, 4 - ` .
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Town Hall, 53095 Main Road o �,4?::; fi Construction
P. 0. Box 1179 cn '
Southold, New York 11971O.•cb
• Alteration
01
Telephone44 V- 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.
Fee .$
DATE 6 -1C/ -9/
APPLICANT NAME: UJNG�1->T' . SON TJ
APPLICANT ADDRESS: ? p, ,x 3 M 1 / /\L /7 4
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: J
OWNER MAILING ADDRESS: 170 S r
• 91R 11061
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: V?-00.7._.7.---
TAX
?-Qoz-�TAX MAP NO. : Section CI(/ Block 3 Lot LI . /3
_ CROSS STREET: SOtitip Va-Vr--
BUILDING PERMIT NUMBER CROSS REFERENCE:..
10.1/404j W,g07.k
Signature of Applicant
RECEIVED BY:
(TOvn /Clerk's Office
DATE: Fi
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SINGLE FAMILY DWELLING ONLY I,EXPIRES MVO YL;ift$ FROM DATE OF APPROVAL APR 24 1y 91
Sr.DEPT Pr
SURVEY FOR
JEFFREY GATZ & MARY ELLEN GATZ
0UFFOLK COUNTY DEPARTMENT Of HEALTH SEEY10E5 LOT NO. 13, " HONEYSUCKLE HILLS"
AT MATTITUCK DATE. APR. 9,1991
FOR APPROVAL OF CONSTRUCTION ONLY TOWN OF SOUTHOLD SCALE, I"=50'
DATE MAY 2'z 1991 HS REF.NO. 7)'5 -31
SUFFOLK COUNTY, NEW YORK NO, 91 0267
+uwuTNORI[(o 444444 TION of Aoo,r.ow ro Nil CERTIFIED TO,
7 SUAVE.D A VIOLATION OF SECTION 12011 OF TNM JEFFREY @
. •�. N(W.ORP STATE EDUCATION L••
pit L N AIF
APPROVED _ ----.1. \ rcorl[f Or TNI!wRv[.NOT SEARING rN[LAND . •. TIONAL BANK RVEYOAS INREO SEAL OR EMFOLSEC SEAL!MALL 0 W
.jLS S L/� ;�I"�7T — NOT SE CONSIDEA{O.0R A NAL t 0 ,NV t[Or. °MO' YOG T'\
ROU AAANTELS INOMATEO NORTON SMALL *Of O.L.TO
HEALTH DEPARTMENT-DATA FOR APPROML TO CONSTRUCT T11f ON NIS FOR•F TO TN[SLILY[, i1 r+trA+ED * i G
AMO PI NIS FOR V/ TO TN[TITLE COMPAN..00,4116,I•ED
•NE ATER ems NI • •0OVNCE OF•ATIN MINT[_PIALIC_ MENTAL AGENCY AND LENDINA'NET ITUT i ON L'SKD •lj5`j
•RIF co TAS NAP DMT'000 DICTION_39_SUMP�_LOT 4.1 MLRION,AND TO TNT ANSIINILS OF TA(LENDINA '(%��
OMEN ARE ID OWILLNNN WITHIN 100 FEET OF TINS PROPER.. INSTITUTION GUNAANT{LI ARE NOT TAM AA "'���%%%
OTHER THAN THOSE SHOWN N[N(OM TO ADDITIONAL INSTITUTIONS OP SUSS(OVLNT ^"
OMENS
•TWO DATER SUPPLY ANO Do•ASl gSPOSAL STSTW PON MIS ROIOEIQ h 3
WILL CONFO•N TO TML STANDARDS OF THE SUFPRR COUNTY •DISTANCES STRuC NONCOM FROM **OPER?.LINES I ` O.4589
Of_ TO LSIDTIM11 STAUC TURD ARE TON A fP{CHIC �•!'V. `
WI-IC/MT.TN 1f 1 �JN� PURPOSE AND ARE NOT TO S[Uf(D TO[1TAlLISN O(AND SVS,+ a
V I ICU—IV 1 I PRO►(PT. LINES ON ION THE LP[CTION OF FENCES
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NOTE. IV STAKE
ALDEN W YOUNG,PROFESSIONAL ENGINEER
SUBDIVISIONFOLK MAPON FILEDC IN THE OFFICE FILE NO.TH7 19 OF AND LAND SURVEYOR NYS LICENSE NO 12945
SUFFOLK COUNTY OCT. 16,1981 AS NO.7019.
HOWARD W YOUNG, LAND SURVEYOR
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• N LOCArns OFWI,LIWI,DORISIC TANNINTCISSPOOLGICRSOWNUIN 1[111011 NY S.LICENSE NO 45993
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