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HomeMy WebLinkAboutBauso, Greg ELIZABETH A.NEVILLE,MMC �� �� Town Hall,53095 Main Road TOWN CLERK ���,�: � P.O.Box 1179 t®` Southold,New York 11971 REGISTRAR OF VITAL STATISTICS Fax(631)765-6145 MARRIAGE OFFICER ��^ �'' Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK D TOWN OF SOUTHOLD SEP 292016 Do TO: SoutholdTownBuilding Department BUILDING DEW. FROM: Sabrina Born, Southold Town Clerk's Office TOWN OFSOUTHOLD DATED: September 28, 2016 Transmitted herewith is a copy of application No. 4429 for a Cesspool/Septic Tank ALTERATION Permit submitted by: Latham Sand& Gravel.Inc. for Greg Bauso 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 I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE" DISAPPROVE Comments: Maintain required setbacks from adjacent wells,buildings,property lines and water Bodies. EXCAVATION INSPECTION RECEIVED � ` OCT 1 2 2016 Signature Southold Town Clerk Dated 3 ' y 4 ELIZABETH A.NEVILLE,MMC ��® Town Hall,53095 Main Road TOWN CLERK P.O."Box 1179 - COW® " 0.�XW � Southold,New York 11971 REGISTRAR OF VITAL STATISTICS Fax(631)765-6145 MARRIAGE OFFICER 41 Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER u OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD October 14,2016 John Hocker Latham Sand&Gravel, Inc. ' PO Box 608 Peconic,NY 11958 RE: 31.-8-3 (Greg Bauso) Dear Sir/Madam: Enclosed herewith is the Construction, Alteration or Modification Permit for a Septic Tank/Cesspool System for which you applied. AFTER the system is installed but prior to being used, an OPERATION PERMIT IS REQUIRED. The operation Permit is issued by the Southold Town Clerk's Office. The fee is Ten Dollars ($10.00) for a residential system and twenty-five dollars ($25.00) for a non- residential system. Your check should be made payable to the "Southold Town Clerk". An application form is enclosed. Please complete the requested information and return the application, proper fee,• and LOCATION MAP (map must indicate the location of the cesspool(s)/septic tank(s), giving approximate distances in feet from any buildings to the pools and distances between the pools. Should you have any questions concerning this matter, please do not hesitate to contact this office. Very truly yours, Sabrina M. Born ' Clerk Typist Enclosures 4 SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 4429 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : LATHAM SAND & GRAVEL, INC. Address 1: PO BOX 608 City St zip PECONIC NY 11958 Descripton of Proposed Construction or Alteration ADDITION TO EXISTING SYSTEM APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. Name Of Owner GREG BAUSO ------------------------------ Mailing Address 1 128 67TH STREET ------------------------------ ------------------------------ City St zip BROOKLYN NY 11220 -------------------- -- ---------- Property Address 1 9100 MAIN ROAD ------------------------------ ------------------------------ City St zip EAST MARION NY 11939 -------------------- -- ---------- Tax Map No. section 31.00 block 8 lot 3.000 ------ --- ------ Cross Street BAY AVENUE ------------------------------ Building Permit Number Cross Reference: ---------------------------------- Issue Date: 10/14/16 Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) F01/( ELIZABETH A. NEVILLE,MMC Town Hall,53095 Main Road TOWN CLERK P.O. Box 1179 CA Southold,New York 11971 REGISTRAR OF VITAL STATISTICS w Fax(631)765-6145 MARRIAGE OFFICER Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Sabrina Born, Southold Town Clerk's Office DATED: September 28, 2016 Transmitted herewith is a copy of application No. 4429 for a Cesspool/Septic Tank ALTERATION Permit submitted by: Latham Sand & Gravel, Inc. for Grea Bauso 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 I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE DISAPPROVE Comments: Maintain required setbacks from adjacent wells,buildings, property lines and water Bodies. EXCAVATION INSPECTION REQUIRED. Signature Dated EI ZABETH A.I'qEVItJE �� �� Town Hall,53055 Main Road TOWN CLERK P_O.Box 1179 4 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS +rf MARRIAGE OFFICER ®,� ! �e Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER southoldtown.northfork_net OFFICE 4F TIM TOWN CLERX TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT PLICATION CONSTRUCTION or ALTERATION PERAHT CESSPOOL or SEPTIC TANK Residential @$10_ or Non-Residential @$25 Application No. Permit No. Applicant Nance !`�n I- f`Ic d� �6-a��1 ( �`f- C��'�L I :.:1.,')C Applicant Mailing Addres .. Y `�6,n i C 67(4I) -51 Septic'Tank or Cesspool Brief Description of Proposed Construction or Alteration72-tqN.- < t i� (-n L ?` h �©C'.r�-�;ot? �-c7 ��.��of�- CG-�d�t� 9a�ral-fh ��✓;e.�:;��c ¢;ct;�� Location of Proposed Construction/Alteration: Owner of Property: 6 c 2 Owner Mailing Address: Ower Property Address: n--)a,<` ,'-P-d Name and phone number of contact person 7)C>I)f-) 72114- 6 eOC) Tax Map No: 16 Section -31 .Block C1 ij Lot 6 7 Cross street a NOTE: LOCATION MAP MUST BE SUBNHTTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES S7EIEURVEE NT APPROVAL Signature of Applicant Date Deceived by: O j•` X01'S \ :.°.:.�: 'try �O�ti9• �`� �CP. J • a 0 _ \ oN AI kp 0000.E 1 F. �' `� -=•O• `� •y06 2 �Zp pJ cG o cry .ry J.+•.• y �i � •. _ o. yip OJS6 � DQE & / oo kp s �0 00, 4pOO•�9�� � t o• �y ,p F � GE oN 13� pRpJ�O