HomeMy WebLinkAboutFrenz, Tom oil OF FOLit
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ELIZABETH A. NEVILLE ��= Gy� • Town Hall, 53095 Main Road
TOWN CLERK ; y P.O. Box 1179
REGISTRAR OF VITAL STATISTICS v' /�, Southold, New York 11971
MARRIAGE OFFICER 4' Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ``may"'/Q! 41.1,„0 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER _ •1��
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2245 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : TOM & PAT FRENZ
Address 1 : 1260 BROADWATERS ROAD
City St Zip CUTCHOGUE NY 11935
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 #R10-96-49
Name Of Owner FRENZ, TOM & PAT
Mailing Address 1 117 QUEENS COURT
City St Zip MASSAPEQUA NY 11762
Property Address 1 1260 BROADWATERS ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 104.00 block 9 lot 4.002
Cross Street VANSTON ROAD
Building Permit Number Cross Reference:
Issue Date: 2/18/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE '10 G'j� Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS v' t� Southold, New York 11971
MARRIAGE OFFICER : ,f�il. �����, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER '/Ql *$ ,•' Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER g.��.9"
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: February 17, 2000
Transmitted herewith is a copy of application No. 2333 for a Cesspool/
Septic Tank Construction Permit submitted by:
Tom and Pat Frenz by Thomas Samuels
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
DISAPPROVE
Comments:
gnatu
Dated
7F-FICE OF THE TOWN CLERK _ ;fit\-FF:71A-; <_
Town of Southold Q
Judith T. Terry, Town Clerk --,...-;,c.-,--,-'7_-,...--?_. . "
S?� Application No.
Town Hall, 53095 Main Road r `t" ' , C
P. O. Box 1179 u' �'�` ��?I„ fn Construction
Southold, New York 11971
����; _
�� Alteration
Telephone 'Ol i �b 1Cv Residential
(516) 765- 1301 �,rJ�
Non-Residential
TOWN OF SOUTHOLD
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SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
gFCE VED
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for
CONSTRUCTION or ALTERATION PERMIT FEB
SEPTIC TANK or CESSPOOL "°°� �� tpwriClerk
Permit No.
Fee $
DATE 02/W0-0
APPLICANT NAME: hcJ? crJat_
ize��O
' ?- _ A-Ree5`17e
APPLICANT ADDRESS: /26 S�'DQdiU - £`�, .25-23.5" 2a. -# ,. -,11
APPLICANT
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SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit maybe
issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 772,
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• OWNER MAILING ADDRESS: /
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Co r
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OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT. PERSON: L ' l
TAX MAP NO. : 1 ,3
NO. :
���0`S
Section �d Block Lot 4/1. .2
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CROSS STREET:
Q
BUILDING PERMIT NUMBER CROSS REFERENCE:_.
OP I
Signature of 40r, � a '
Applicant
RECEIVED BY: /�,
Tof n rk
Cle 's Office
DATE: ti /
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SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES =
PERMIT FOR APPROVAL OF CONSTRUCTION FORA 4,
OEC giLt§tMILY RESIDENCE ONLY c 5 �, • ' _ :-
DAIS HO -Q .- — . . _-
APPROVED ? ."
FOR MAXIMUM OF BEDROOMS
MOIRES THREEYEARS FROM DATE OFAPPROVAL
AUU 1 2 1999 ---.7:a q r/777(
Su ecr To CtDYPriARTS 4 ISE?RicTtGtdS 1t3cA / ' I4'° C• 4_,L7./1 `
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Is- r,
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Approved in accordance with r of Review
,- 'PA '�'o. la3g�
determination dated.. I • i' w-
F0PNEW.4
its //I//
Project No:
x'912
I Drawn By:
LiT
Checked By:
TS
Date:
7 / i� /99
Scale:
AuNcrE7
Sheet Title:
SITE
PLAN
ISheet No: