HomeMy WebLinkAboutJLC Management ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER ~-C~.~''-
FREEDOM OF INFORMATION OF.EICL~.: ~*f'.
~'~,, ..~-'- :' ~FFi~\OF THE TOWN CLERK
k'~ ,~ ,~k~ \ ~ XTO~N OF SOUTHOLD
TO: S~~mg Dcpa~mcnt
FROM: Linda J. Cooper, Southold Town Clerk's Office
To~vn Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
sout holdtown.nort hfork.net
DATED: May 18, 2005
Transmitted here~vith is a copy of application No. 3454
Permit submitted by:
for a CesspooVSeptic Tank Consmtction
JLC Management Inc.
Please revie~v 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 remm it to me.
Linda J. Cooper
I have reviexved the application and location map of the project cited above and make the following
recommelldations:
APPROVE /
DISAPPROVE
Comments:
Signature
Dated~/4
ELIZABETH A. NEVII,I,I~ '. --
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
.. Town Ha~l, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
Residential ~ $10~
CESSPOOL or SEPTIC TANK
or Non-Residential ~ $25 __
Application No. ~
Permit No.
Location of Proposed Construction/Alteration:
Ow,~er ofrrop~y: ~4-&g.
Owner Property Address:
Name and phone number of contact person -)o~'~ (4~ger~ / 6 ~/- g ?q - 7 a 7 7
Tax Map No: /~ Section ?-/"0. Block ~ Lot .~, ~
Cross Street ~2~ e ~,.4 f f J~ , e4 .
NOTr: LOCATION ~ ~ST S~ ~r~rrEv/~ AP~'LIC~TION.
CONSTRUCTION ~Q~S S~Y ~H ~H D~~ ~PROV~
S.C. TAX MAP NO.' DIST. '1000 SECT. 4-0 BLOCK 3 . LOT 3.2 IFILE I:,10. IPROJECT NO. 04-0590
N
S
56.0'
I) O~IELLIN~D P'IITHIN 150' UTILIZE PUBLIC HATER.
2) PP-.OPO~,EO ELE:W'ATION~ AW45 UNOEW. LIN50.
~) I4.W.J. ALL RIGHTS RESERVED.
NOTE, 5ANITAP--¥ 5"r'ET~M TO DE C, OMF'P-.15,EE)
OF 'T].~O C.~5POOL5 ,D' IN DIAMETSR
P,I[TH AN EFPF:CTI'v'E DEF:q-H OF ,D,' EACH AND
A SEPTIC TAN'~. OP 1OOO CALLOND
CERTIFIED ONLY TO:
By
MATTHEW 0. CRANE N.Y.S. LIC, NO. 050065 L.S.
OES,~,Eo } DRAWN C.W.O. I CKO. U.C.
TEST.HOLE # 1
PROJECT:
SITUATE AT:
DATE: JANUARY 2005
SURVEY DATE: 1/4./2005
FILEB MAP NO
FIELD BOOKS bk.478 p.56
FNB, ,
PAROEL #2 ON THE MINOR .GUBDIVI_~ION
FOR A,L.R, P'RANOISO0
SOUTHOLD, NEW YORK
SCALE: 1 "=50'
AREA 1.71 ACRES
DATE FILED
DATA DISC 04-0590
UND. CONST. FINAL
HA~INS WEBB JAEGER PLLC
~GINEERS-~RCHITECTS-~JRV[YORS- PLANNB~S