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HomeMy WebLinkAboutWhalen, Terence ,'°�,o��Sf�FFO�,�co • ELIZABETH A.NEVILLE ���= G# ; Town Hall, 53095 Main Road TOWN CLERK ` o yP.O. Box 1179 REGISTRAR OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER : �,it, � �1�, Fax (631) 765 6145 RECORDS MANAGEMENT OFFICER = "'/Ql a0'i. Fax (631) 765-1800 FREEDOM OF INFORMATION OFFICER ,,,,,��� OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 2257 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : EAGLES NEST HOMES OF L. I . Address 1 : 4 FERNWOOD DRIVE City St Zip COMMACK NY 11725 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 #R10-00-0026 Name Of Owner WHALEN, TERENCE & ANN MARIE Mailing Address 1 14 FIRST PLACE City St Zip GARDEN CITY NY 11530 Property Address 1 THE STRAND City St Zip EAST MARION NY 11939 Tax Map No. section 21 .00 block 5 lot 72.000 Cross Street THE GREENWAY Building Permit Number Cross Reference: Issue Date: 3/01/00 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) aas7 ,o�SUFFO�,�0 ELIZABETH A. NEVILLE • Town Hall, 53095 Main Road TOWN CLERK C - P.O. Box 1179 W Southold, New York 11971 REGISTRAR OF VITAL STATISTICS .F �� Fax (631) 765-6145 MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER ��y?Ip *p ,,I Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER _ ii" OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: February 25, 2000 Transmitted herewith is a copy of application No. 2343 for a Cesspool/ Septic Tank Construction Permit submitted by: Eagles Nest Homes Of L I for Terence & Ann Marie Whalen 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: ignatu art / 6 a Dated t J OFFICE OF THE TOWN CLERK '1 1'��I'"•••••K••,/���; TOWN OF SOUTHOLD ,l' C��FF�[ "`Q Application No.c2.-jy� ELIZABETH A.NEVILLE,TOWN CLERK X.` P.O.BOX 1179 Z; Construction l SOUTHOLD,NEW YORK 11971 i v rrt Alteration U Telephone ,%0` �Q�►� $10.00 - Residential (-> .___(516) 765-1801 "-y11 � •0'" $25.00 -Non-Residential „,,,,,01 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICAT ION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee $ DATE 2/�-/ 4, APPLICANT NAME: /A / i rs /0( er //e ,yh r CF 1, j , APPLICANT ADDRESS: I ,i AN Leo B P d 4 1✓ f CSP Aj P// OR N X 7/ 71-(- SEPTIC 'SEPTIC VN ESSPOOL DESCRIPTIONS OF PROPOSED CONSTRUCTION OR ALTERATION re ,, 3[4 11(1 r tS'/NOR //Pay / eT i' D/fWit LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: pw:U pJE 4_ A'uN , /sii //L wJ74 A A 1.1 OWNER MAILING ADDRESS: /V /'/fx r Q42J/p r fl eAR PIti cl, Ny os-J D OWNER PROPERTY ADDRESS: /6,64/4 i RA (+I' Ild// Cr7f/i/v 0 S S r M /rD d P -r- C1 -10)1 .36 cl"1 9 TELEPHONE NUMBER OF CONTACT PERSON: C "'5 — 7/�_ )cr.A.7s.-4 /�- TAX MAP NO. : Section 0 / Block ,S— Lot 7,a, CROSS STREET: Ihl ,t -'0-1?,e ,✓1 s BUILDING PERMIT NUMBER CROSS REFERENCE: 1 /� ' / '�1 / / . L ,�. i«/ I. _ i, ,, s ,:ate J444 . Signature o .,'i plicant RECEIVED BY: Le. Tow Clerk's Office DATE: D____-/ _•SO� t ` i M-S r , f • w� s'f PLEASE NOTE � . n , LL /c `a Sanitary system is not to be :"1/0 LOCATED Ar,. mAgioo , 1'/o-4Park r ? , 11Y placed under driveway area. ' LOT ,_,\ , , MAP OF r ,_ ,:,'f '- , SUFFOi.db COUNTY F,EPA RTIC'iu'i i O1 HEALTH SERVICES f\ SCALE 1"...It', GZG(0 b-II-T4? --r-i-t . G 4, M i�7L /1--\•-L- 1"E�i. ?` �.�:;r�a`►�.1.,Or�:`�:-��-,,'}�3 T �:t a nil A S +F'M*' ,rs- R- SRS) 1-"2veyy ,i',t 9 s :isl. 1 AM iL EN : ONLYC2- LAW f317 . 10-- 2I ; . ah.-0- t3Powtu Pi DAT ....2.-_-_9_,L.-©_0 1-16 au.1.10. '/0. it0. 002 e.- meow r, SfvuP i 3 D II APPROVED AarAI- L- -— = ••� eRw�tFOR MAXI 1JM Or Li 13E 0 5 'MS:" GI-Pry EXPIS THREE YEARS FROM DA E OF APPROVAL a 1"" ici_ , of.,„..)r> _. i it . Frvw/a F -t0 To G1vta.4e eN-fti7 L..t,�-r 8a 3 kr et 6/A G) EXCAVATION INSPECTION R�=,^xvlRtED 1 \ , M 44" - FOR SA1\IITARY 7.3'.1.:7,7-".`1 ,1s \ , s , 1 , s i , Fly Ha,I -rt.1 r•,,- •-• - \ 9 c ,rte :Iiisus ' 1604v at- A •, .-S- si\1,, \.. In I. -.4 , ; 3 q ,A a -. • VSURVEYED t. 21 Y 4 kf it AgeS ` WILLIAM R. SIMMONS IU, L.S.P.C. g — 11 MEROKE LANE • EAST ISLIP, L.L, N.Y. 11730 (516) 581-1688 Fax: (516) 581-1691 FILE NO. ---2/4.---74PAGE GRID r AW110 OV