Loading...
HomeMy WebLinkAboutGazza SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 4477-R Residential X Non-Residential Fee $ 10.00 New Existing X Name Of Owner ROBERT GAZZA ------------------------------ Mailing Address 1 2850 CEDAR BEACH RD ------------------------------ Mailing Address 2 ------------------------------ City St Zip SOUTHOLD NY 11971-0000 -------------------- -- ---------- Property Address 1 2850 CEDAR BEACH RD ------------------------------ Property Address 2 ------------------------------ City St Zip SOUTHOLD NY 11971-0000 -------------------- -- ---------- Owner Telephone No. 631-765-1471 Tax Map No. section 91.00 block 1 lot 3.002 ------ --- ------ Cross Street SUNSET WAY ------------------------------ Issue Date: 12/22/14 EMzabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) A-(z AUS S c� 0 22-t / C�SSPt?�L i I) O�©" o 2 S© C&DAR �oSUFFot,��, �O �G ELIZABETH A.NEVILLE 2 y� Town Hall, 53095 Main Road TOWN CLERK y = P.O. Box 1179 REGISTRAR,OF VITAL STATISTICS O Southold, New York 11971 MARRIAGE OFFICERy • �� Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER l �aO Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION OPERATION PERMIT CESSPOOL or SEPTIC TANK Residential @$10 or Non-Residential @$25 Application No. 7 7 Permit No. Y0 70 Owner Name ! l 6,--g Owner Mailing Address Owner Property Address /L J� -rte c P At �� r ` -7 Owner Telephone No. 14 7 ( Tax Map No: Section 71 d o Block Lot 3 ; ®d a Cross Street S'v /V S e T tv A Y Please check each that applies: New Construction Alteration to Existin System 1/ Residential_ Non-Residential NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. (Locate building and system; give north arrow and approximate distance in feet from system to building and closest road. New construction may submit copy of survey with SCHD approval.) Signature of Applicant Date Received by: SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 4270 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : MORRIS CESSPOOL SERVICE Address 1: 2760 YENNECOTT DR City St Zip SOUTHOLD NY 11971 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 ROBERT GAZZA ------------------------------ Mailing Address 1 2850 CEDAR BEACH RD ------------------------------ ------------------------------ City St Zip SOUTHOLD NY 11971 -------------------- -- ---------- Property Address 1 2850 CEDAR BEACH RD ------------------------------ ------------------------------ City St Zip SOUTHOLD NY 11971 -------------------- -- ---------- Tax Map No. section 91.00 block 1 lot 3.002 ------ --- ------ Cross Street SUNSET WAY ------------------------------ Building Permit Number Cross Reference: ---------------------------------- Issue Date: 11/18/14 Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) o�r4S%SfFO(,rco ELIZABETH A.NEVILLE,MMC �� r/y Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 H = Southold,New York 11971 REGISTRAR OF VITAL STATISTICS p • Fax(631)765-6145 MARRIAGE OFFICER 'y� ��' Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER J �a www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Carol Hydell, Southold Town Clerk's Office DATED: October 17, 2014 Transmitted herewith is a copy of application No. 4270 for a Cesspool/Septic Tank ALTERATION Permit submitted by: Morris Cesspool Service for Robert Gazza 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 TO: Southold Town Building Department FROM: Carol Hydell, Southold Town Clerk's Office DATED: October 17, 2014 Transmitted herewith is a copy of application No. 4270 for a Cesspool/Septic Tank ALTERATION Permit submitted by: Morris Cesspool Service for Robert Gazza 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 •� o��sUfFO��-c ELIZABETH A. NEVILLE �`Z` �G.y Town Hall, 53095 Main Road TOWN CLERK p P.O. Box 1179 y = Southold, New York 11971 REGISTRAR OF VITAL STATISTICS v+ f-py MARRIAGE OFFICER O Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER a'� �a southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential $10 /or Non-Residential $25 Application No. �7 @ @ Permit No. Applicant Name o'/���► S lG,/�s ` 54iX Applicant Mailing Address22&�—,& YW Cd Q/Q Septic Tank or Cesspool Brief Description of Proposed Construction or Alteration 2l-1J'!4 Location of Proposed Construction/Alteration: Owner of Property: P,-Okkkr 62t 22-4 Owner Mailing Address: 2_aSp C tf_i4x J6LA1_11 /0 Owner Property Address: Name and phone number of contact person Tax Map No: Section 91 Block�_ Lot Z Cross Street Sttdts e� NOTE: LOCATION MAP MUST E SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SUR WITH EALTH DEPARTMENT APPROVAL Signature o Applicant Date Received by: C�