HomeMy WebLinkAboutFritscher, Carl . . ��, ��S�FFik,,
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JUDITH T.TERRY Q1�� yl' Town Hall, 53095 Main Road
TOWN CLERK y P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS �
�
MARRIAGE OFFICER % aQ '/ Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER 4! Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER i"
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1761 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : CARL FRITSCHER
Address 1 : 12 ROMA AVENUE
City St Zip CENTRAL ISLIP NY 11722
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-97-0146
Name Of Owner FRITSCHER, CARL AND WIFE
Mailing Address 1 12 ROMA AVENUE
City St Zip CENTRAL ISLIP NY 11722
Property Address 1 PINE COURT & PINE TREE EXT
N/E CORNER
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 98.00 block 1 lot 7.015
Cross Street PINE TREE ROAD
Building Permit Number Cross Reference:
Issue Date: 10/29/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY '1�=� y1't Town Hall, 53095 Main Road
TOWN CLERK ; CO3 P.O. Box 1179
v ,u' Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ; �1 Fax(516) 765-1823
MARRIAGE OFFICER #4. %N.#800° Telephone Telephone(516) 765-1800
RECORDS MANAGEMENT OFFICER I `1► ,��
FREEDOM OF INFORMATION OFFICER .,,, r 104°11
L5 N 11
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD OCT
J 1997
TO: Southold Town Building Department BLDG. DEPT.
TOWN QF SOUTHOLD
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: October 28, 1997
Transmitted herewith is a copy of application No. 1835for a Cesspool/
Septic Tank Construction Permit submitted by:
Mr. and Mrs. Carl Fritscher
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 reco mendations:
APPROVE
DISAPPROVE
Comments:
ri
Si ature
Dated
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(}}11[L UF .1.||E TOWN CLERK �� COI Ik4
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Town of Southold �
Judith T. Terry, [owo Clerk /\p|JicaUon Ho.
[.,w/` Hall, 53095 Main Road ��--'
tn Construction
P. U. Box 1179 -' - -
Southold, New York 11971 Alteration
Telephone
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(516) 765- 11101
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TOWN OF S0UTH0L0
SUUT||8LU WASTEWATER ATER NS|'0SN- U\ST|z|CT
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CONSTRUCTION or N [( RATION PERMIT
• SEPTIC TANK or CESSPOOL
Permit No.
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Feu $ ___ ____
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UATE � 7�� -�
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APPLICANT NAME : A?' ��
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APPLICANT AU[)AESS: � ^J ^� vv
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0EPT|(� �_ CESSPOOL
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DESCRIPTION OF PROPOSED CONSTRUCTION OR A| TER/\
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LOCATION MAP: Must be attached hereto before permit may be Issued.
• LOCATION OF PROPOSED C<)NsTRUCT |UN OR ALTEKATION :
OWNER OF PROPER TY :
OWNER MAILING ADDRESS: __ _
OWNER
/4-ye "t/.4/C COCl/r/Y"
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TELEPHONE NUMBER OF CONTACT PERSON : A ��-��~/�� ^�
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[/\X MAP NO. :� SecUon CM' |U'^�� �� � |.o( � ��
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CROSS STREET : r~m/-e
q-~ \ '� BUILDING PERMIT NUk413E|< CROSS REFERENCE : �^
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TEST HOLE DATA ,
(TEST HOLE DUG BY McDONALD GEOSCIENCE ON AUGUST 15, 1997)
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P *0, WNW WO'WM OL
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SUFFOLK COUNTY DTPARTMENT OF HEALTH SERVTC2S 1 .
•
uNATHORIZED ALTERATION OR ADDMON
PERM FM APPW)YAL OF CONFIIRUCTION FOR A TO THIS SURVEY IS A VIOLATION OF -,...
FAMILY RIED/140101'4LY SECTICN 7209 CF THE NEW YORK STATE
EDUCATION PM.
-
9 ,.,,-7/, ,i)7-, ,o..asp, No j-zz*.........,..........- ., L
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COPIES OF THIS SURVEY MAP NOT BEARYNG ' . .
DATE THE LAND SURVEYORS INKED SEAL OR
EMBOSSED SEAL SFIALL NOT SE CONSIDERED • 1
l' ‘, ,- v TO SE A VALID TRUE COPY. ;
APPROVED_
CERTIFICATIONS l'iDICATED HEREON SHALL RUN
FOR MAXDAIM OF..i..BEDROOMS ONLY TO THE PERSON FOR IOM THE SURVEY
IS PREPARED. AND ON HIS BEHALF TO THE
TIME COMPANY. GOVERNMENTAL AGENCY ,-
EXPIRES THREE YEARS FROM DATE OF APPROVAL LOVING INSTIRMON USFED HEREON.-ANDAND
TO THE ASSIGNEES OF THE LENDING INSTI- „,
TUTION. CERTIFICATIONS ARE NOT. TRANSFERABLE.
. .,
LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD THE COSTANCE OF RIGHT Of WAYS-
:RVATIONS AND/OR DATA OBTAINED FROM OTHERS. AND/OR EASEWDFFS OF RECORD. IF
ANY. NOT SHOWN ARE NOT GUARANTEED.
....,..!
IIMINIIIIMMIIMIM -
1ED IN ACCORDANCE WITH THE MINIMUM --.. •
ce,
OS FOR TMESURVEYS AS ESTABUSHED
UA . AND APPROVED AND ADOPTED .Joseph Aingeno '±t)
_ ..._ BY THE NEW YORK STATE LAND A.
-,
• '84! ' .,,
m. iii:o: , Land Surveyor ,.
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Ir_. Title Surveys — Subdivisions — Site Plans — Construction Layout -..
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PHONE (516)727-2090 ...
Fax (516)722-5093
.,
r.7 4O OFFICES LOCATED AT MAILING ADDRESS
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a _ N.Y.S. Lic. No_ 49668 One Union Square P.O. Box
T Aquebooue, Nei York 11931 Frnertiead. NeWYeet( 1190/:.
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