HomeMy WebLinkAboutSenenfelder, Thomas I
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OI ELIZABETH A.NEVILLE ol/ Town Hall, 53095 Main Road
TOWN CLERK = < P.O. Box 1179
cc,) �2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Fax (516) 765-1823
MARRIAGE OFFICER �` �o a� � Telephone(516) 765-1800
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER * si
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1973 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : JAMES E. FITZGERALD JR.
Address 1 : P. O. BOX 617
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 #R10-98-0156
Name Of Owner SENENFELDER, THOMAS
Mailing Address 1 (CONTRACT VENDEE)
P. O. BOX 336
City St Zip SHOREHAM NY 11786
Property Address 1 220 NORTH CORSS ROAD
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 103.00 block 13 lot 27.000
Cross Street PEQUASH AVENUE
Building Permit Number Cross Reference:
Issue Date: 11/23/98 zabeth A. Ne ille
Southold Town Clerk
(TOWN SEAL)
I �2
,eStFFoLA-�o
ELIZABETH A.NEVILLE y� �0 r/y Town Hall, 53095 Main Road
TOWN CLERK = < r P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
I Fax (516) 765-1823
MARRIAGE OFFICER Z O
RECORDS MANAGEMENT OFFICER Ly O� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER _�O./ 4. -00
•�'�iii /we
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: November 16, 1998
Transmitted herewith is a copy of application No. 2049 for a Cesspool/
Septic Tank Construction Permit submitted by:
James E. Fitzgerald Jr. for Thomas Senenfelder •
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:
ignature
I1 JLI !tig
Dated
�Ad -1 €
OI CE OF :r TOWN CLERK �••1r,r'yr••-���
TOWN•F SOUTHOLD
.••1Ca�� �tk4Q = Application`N I I
SOUTHOLDELIZ?.BEfH A.iv " . ..• . ll*RK
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PO,DOX 1179 $ NES Construction
SOUTHOLD,NEW YORK 11971 '^
len Alteration
Telephone Q •, $10.00 - Residential
•
(516) 765-1801 46 rr' $2 .00 --Non-Residential
•
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ 0 __OQ.
DATE I1/ CV 95�. . _ .� - ----
APPLICANT NAME:
APPLICANT ADDRESS: __ _p
ger - .N\E . 1,097--
SEPTIC
,09ZSEPTIC f CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
_Nein_ _Cont - -- rms_c- 2 s y y —_
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: :Li I1 a AA' : , it"....
• •
OWNER MAILING ADDRESS: _ @.vx ln.
OWNER PROPERTY ADDRESS: 27,i j.j_„gs �Q .L ____._", _
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TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section i I l Block 0 3 Lot I Z
CROSS STREET: 10
_4 WQ 5
BUILDING PERMIT NUMBER CROSS REFERENCE:
•
ignature of Applicant
RECEIVED BY :
Town Cler'k's Office
DATE:
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Recetve
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Suffolk County
Iwo* OCT 141998
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NA17 . �t. Of Haateltn 3elvices" 1�`� alr , `` D `� C a .
VOL ivt hE AV' Lie- P 4o. 1(03 4 2.8)I xo
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LTH SERVICES
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Institution list-• r,• L assignees of the lendin• stitu ions• s r/t�i•P J
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Sell shall not be conside •a valid true copy. ��
AP`L ti•!4A Ott or dmensbns)shown hereon fro atru«. * - e ' (� 1 0 — O f �-f 1 ja i
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fences,retaininpg(w�aallls,pools,patios,planting
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.rte i.` /1\ O LAND SURVEYOR
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'`" 73 WOODLAWN ROAD
DESTIN G.GRAF N.Y.S. LIC No.50067 �t� .• ROCKY POINT.NEW YORK 11778ci
TAX I.D. No. VP PHONE(516)821-3442
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