HomeMy WebLinkAboutJLC ManagementELIZABETI'I; A~-NEVILLE
TOWN CLERK
~: REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
~ RECORDS MANAGEMENT_OF. FICER
~kEEDONi OF.~IlqF~)RM~T~)I~ OFFICER
~_~ '~ . ~;-.~ ..~ .
~.~'.~ . ', ~ '2'.~':, OFFICE OF THE TOWN CLERK
}!..~, ~ i . : ~ TOVCN OF SOUTHOLD
· T,~'-~'- Southold Tox~m Building Department
Town Hall, 53095 Main Road
P.O. Box 1179
Southold~ New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southold~owmnorthfork.net
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: July 13, 2004
Transmitted herewith is a copy of application No. 3346
Permit submitted by:
for a Cesspool/Septic Tmrk Construction
JLC Management, Inc.
Please re,new the application and location map and advise if the project has received Suffolk County
Health Department approval and if rids office may issue the permit.
Please complete the form below and return it to me.
Linda I. Cooper
, I have revie~ved the application and location map of the project cited above and make the following
recomm endatlons:
APPROVE
DISAPPROVE
Comincn~$; ~
Dated
0 ~"['1 C~J OF'f~J.E ~[OWN CLER~
TO ,~i:N OF S~U'I] l OLD
EL]ZA2,ETfl A. NBVILL6, TOWN CLIJRK
SOUTHOLD, NEW YORK 1 i971
Telephone
[516) 765-1801
Application No.
Construction
Alteration
$10.00 - Residential
$25.00 -Non-Residentia!
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PFR/vllT
SEPTIC TANK or CESSPOOL
Permit No,
Fee $
APPLICANT NA/qE: ' ~
APPLICANT ADDRESS:
SEPTIC CESSPOOL x/ ........
DESCRIPTION OF PROPOSED CONSTRUC~ION.:iOR ALTERA?ION
LOCATION MAP;
Must be attached hereto before'Permitmay.be .issued.
LOCATION· OF~ PROPOSED CONSTRUCTION OR ALTERATION;'
OWNER OF PROPERTY: ._TLC Nio cc cme at-
~J
OWNER MAILING ADDRESS: 7
8. alcy. ~
OWNER PROPERTY ADDRESS: ~,~ ~
Lot
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO,: Section -.~O Block
CROSS STREET: ~ C- ~7~r~C-C~,-~
BUILDI'NG' PERMIT NUMBER CROSS REFERENCE;
Signature of ~licant
Map of Lot 18
"Map of Pebble Beach Farms"
Fi[ed: June 11, 1975, Map Number 6266
Situated at East Marion
Town of Sourhold, Suffolk County, New York
DistZct 1000 Section 30 Block 2 Lot 19
/_07- /7
Certified To:
J.L.C. Management
Sum-ise Abstract
.ANTHONY ABRUZZO ILL.&
REGISTERED LAND SURVEYOR
1500 Honons Lane
Southold, New York 11971
(631) 209-0676
su v v n: 20, 200
Scale: 1 ' ~'30' '. ~- '