HomeMy WebLinkAboutFingerle, Michael (2) f I� ,���S�FfO(,�io
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JUDITH T.TERRY % Town Hall,53095 Main Road
TOWN CLERK t H Z P.O.Box 1179
REGISTRAR OF VITAL STATISTICS
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0 ��, Southold,New York 11971
MARRIAGE OFFICER W* Q)' ,�� Fax(516)765-1823
RECORDS MANAGEMENT OFFICER 0.1 ilig 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. 1368 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MICHAEL AND CHERIE FINGERLE
Address 1 : P. O. BOX 1615
City St Zip SOUTHOLD NY 11971
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. #R10-95-0081
Name Of Owner FINGERLE, MICHAEL AND CHERIE
Mailing Address 1 P. O. BOX 1615
City St Zip SOUTHOLD NY 11971
Property Address 1 CHABLIS PATH
City St Zip SOUTHOLD NY 11971
Tax Map No. section 51 .00 block 3 lot 3.001
Cross Street BURGUNDY COURT
Building Permit Number Cross Reference:
Issue Date: 8/14/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY :,` L Town Hall, 53095 Main Road
TOWN CLERK o r-rt 4 P.O. Box 1179
REGISTRAR OF VITAL STATISTICS 'y � Southold, New York 11971
' 0 �- �� Fax (516) 765-1823
MARRIAGE OFFICER =_ A, _� . Telephone (516) 765 1801
RECORDS MANAGEMENT OFFICER '= 1 4 ,i'
FREEDOM OF INFORMATION OFFICER ,,�,,
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: August 4, 1995
Transmitted herewith is a copy of application No. 1419 for a Cesspool/
Septic Tank Construction Permit submitted by:
Michael and Cherie Fingerle •
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: l” 1�rr) SC:>J6`p Q//'
3/- 3-3./
s
Signature
ale / 49_5
Dated
.
OFFICE OF THE TOWN CLERK ,,'""""'% •
Town of Southold ' .1" 001./(``,
Judith T. Terry, Tg ,wn Clerk �' O� �Gy•_ Application No. /C-N77
Town Hall, 53095 Main Road ; `; RConstruction
P. O. Box 1179 o ; Alteration
Southold, New York 11971 tt� I /
Telephone .O . ,%"/ $10.00 - Residential /
�.
(516) 765-1801 l ! ' $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE j Ll` q5
APPLICANT NAME: YVllchae.) ijer k C JJLe H0 ev ie
APPLICANT ADDRESS: PD 151 /(2)
tn/ nc/i /
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: Me ka f Merle- r( og-evict
OWNER MAILING ADDRESS: PO 60( / / .1
SIC) ttOi //q7/
OWNER PROPERTY ADDRESS: C /9LI� rjak
3x21) A t) //q 7 /
TELEPHONE NUMBER OF CONTACT PERSON: '7&
TAX MAP NO. : Section 4J 1 Block 1 0.12) Lot 0 ; V I
CROSS STREET: U 1�qU ►`� COU-A4
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Apar ant
•
RECEIVED BY:
wn Cle k's Office
DATE:
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SUFFO COU-
DEPARTMENT OF Hi-gib ",,,; i' ' _.
FOR APPROVAL OF COI'�l4.�ThUCTION OF f familar with the Standards for
SL'G!E FAMILY RESIDENCE ONLY Ap•royal .and Construction of Subsurface
I DATE JUN 2 8 1995 us REF. No. `\ iC�.61 iQ) S-wage Disposal Systems for Single Family
�� / / R-sidences and will abide bythe conditions
APFROV `
-et forth thereinnd pn the
permit to
EAPIRES THREE YEARS FROM DATE OF • 'PROvAi- onstruct.14A/tri (II"
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