HomeMy WebLinkAboutBaumgrantz, Frederick 0.0
JUDITH T.TERRY , Town Hall,53095 Main Road
TOWN CLERK y Z t P.O.Box 1179
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v0 Southold,New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER *6 �° Fax(516)765-1823
RECORDS MANAGEMENT OFFICER .( * • ,. Fax
(516)765-1800
FREEDOM OF INFORMATION OFFICER '����„ ,,••�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1387 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : ANGELO ACCARDO
Address 1 : 85 FORCE LANE
City St Zip CORAM NY 11727
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. SCHD REF. #R10-95-0095
Name Of Owner BAUMGRANTZ, FREDRICK
Mailing Address 1 103 SIXTH STREET
City St Zip GARDEN CITY NY 0000
Property Address 1 MEADOW LANE
City St Zip MATTITUCK NY 11952
Tax Map No. section 115.00 block 5 lot 7.000
Cross Street NEW SUFFOLK AVENUE
Building Permit Number Cross Reference:
Issue Date: 9/14/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY = Town Hall, 53095 Main Road
TOWN CLERK e/) Z P.O.Box 1179
$ Southold,New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER y� 1Fax(516)765-1823
RECORDS MANAGEMENT OFFICER 49.( 411 `t►�I��� Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER °"6
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
• JP1t INS
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office TM',ffe *REPT`
DATED: September 11, 1995
Transmitted herewith is a copy of application No. 1439 for a Cesspool/
Septic Tank Construction Permit submitted by:
Angelo Accardo for Frederick Baumgrantz
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 l/'
DISAPPROVE
Comments: %' 4/ Co 9S--
J-rxe-117
4.6
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Signatur-
Dat- •
OFFICE OF THE TOWN CLERK ���'"""",.,®
Town of Southold ,,' vollf,
RA** Application No.t4ft
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road Construction
P. O. Box 1179
Southold, New York 11971 " � Alteration
: ` ,` ' • ' $10.00 - Residential
Telephone +
(516) 765-1801 ® �r' r $25.00 - Non-Residential
, , y,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER. DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. •
Fee •$
DATE
APPLICANT NAME: ,aVG,c/a 4c�4,c2> 6
APPLICANT ADDRESS: J2 7e2e/F_ A/; //,>2 7
•
F
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: . c"),preiX 6'Rz
OWNER MAILING ADDRESS: /43- cp ,r/`,l sJj E,
OWNER PROPERTY ADDRESS: , Aaw, N - �/� eV>/-
TELEPHONE
TELEPHONE NUMBER OF CONTACT PERSON: 4ti4e.4.4,da 732-s7c'-'
TAX MAP NO. : Section 74emorpcs Block Lot 7
CROSS STREET: f‘ti ,J7,2 alk
BUILDING PERMIT NUMBER CROSS REFERENCE:
ignature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
1 COuntY Of Suffolk
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; , its •LEASE NOTE
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. .-44:, .`P• It is the ap.11Oant's r- . .nsibillty to
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maintain a.. . ate - • 't distilince
, ,,'T. va between all water sup. - . sewage
•-•„•.•,.: •6 4' die 4• -1 I facilities. , ..1-.
SIOFFOU: COUNTY DEPAITIMIro,IOF SITAMIN BEW•W,1 •:,
fiAti, NEW SUFFOLK AVENUE
FOR AFFROVAL OF., •• , . • ONLY
gr ,,,‘E SINGLE FA1MLY DWIELUI0 ONLY
OATE"P O 5 ''''. mi or',6''.'cit'1-*.5:.-007 — EXPIRES THREE YEARS FRON DATE OF APPROvNi-
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arintov..• ....1.-.... —_4 ...4TATTNI •-,"-.N1( SURVEY FOR
FREDERICK G.BAUMGRATZ 8 RUTH A. BAUMGRATZ
NOTES: ,'' 1..' LOT 42,"MATTITUCK ESTATES,INC."
1 •:MONUMENT 1,12LIND,..,-
2 Ci•STAKE SET',004,424INABERED LATH SET AT MATTITUCK DATE JULY 31,1995
3. SUBDIVISION IAA i41021 IN THE OFFICE OF ' SCALE' 1"240'
TOWN OF SOUTHOLD
THE CLERK OF SA/ LK CO. ON SEPT.9,1965 ,
AS FILE NO.4455 ',t; ',",, SUFFOLK COUNTY, NEW YORK • No. 95.0602
4. ELEVATIONS SHOMNFragcON ARE FROM ACTUAL
SURVEY AND ARE RE ED TO N O.V.0 1MSLI929). 4 umtunsemmto ALTERATION OR ADDITION TO NHS
sullyET is•yieLATION OF SECTION 72011 Or THE S -----
NEN YORK OLICATION LAW
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,' *COPIES OF Tint SAINVE7 NOY 111/01101 TIN LAND ./ ' -4,4
solvergars INKE0 SEAL OR ENDOSEED 21.$14110.1. i --, ,,-144,.. 0
NOT St CONSIDERED TO AL A VALID mug v i.,1 ..,:: ,. : ' :'.. •
,. NOHARANTUS NNLICHTEOTTIEVZINHALrovjg 10 • i ,•,„ -e••(4i.. .,...•
HE ALTH OEPART MEN T•DATA FOR APPRO .TO CONSTRUCT ArNit a NIS 711.451.F TO TM5111Ilt COMPIANT,SOVS011- 4:. '''''S' .,":.
•mgAR(ST NATO SAM An . I SONS,'Or TOTER PAIHNTE_IHNOLiC_ Nista/. AN/ACT AND LINDH'INSTITUTION 4.11110 :
•NSF CO Tu rAR NOT 1020..-SECTIOR.4116.110.0•1...1-t.OT 7 HEREON,AND TO TME ASSIONEES OF INC-LEMAN
•7141La ant NO CAIFtl..LIARIS WITTEN MO!tit OF THIS PROPIOTY INSTITUTION eumuNttn ARE NOT TRANSFERAILE
OTHER TNATT THOSE SHORN HEREON ,",/ TO ADDITIONAL INSTITUTIONS OR SURSEOVENT
•TNE RATER suPo.Y MO siraulE 011PCRIAL*VIVITO FOR MIS A0.0(ACIL
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5.135:11511CSolcond HEREON FROIT PROPERTY LANES
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Of ANAL TN SCINICILS
RILL.ccaloseT To THE sTANOARCAS OF TNE 11101101-IT COuNTY OE AADE X IS TINII5 S Tittle TUNIS ARE FOR A SPECIFIC ,' L„.•,,4 '' ;;,•frier,
' %PURPOSE AND ARE NOT TO SE USED TO 1817 ,•••;;;;i4:1-1 . , ,••••41
APPLICATA/. , • " 7;''Y'",... PRO HK$ OR FON THE EXICTION OF FENCES , -...--z,•••••t......,'"
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