HomeMy WebLinkAboutJahn (3) P '-r
4r2 _ %• Town Hall, 53095 Main Road
t. `i of �,� P. O. Box 1179
Im at. ��0. Southold, New York 11971
ir
JUDITH T.TERRY -1 ,,,,,,,, FAX(516)765-1823
TOWN CLERK TELEPHONE(516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 654 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : RODICK CONSTRUCTION CO.
Address 1 : P. O. BOX 494
City St Zip MILLER PLACE NY 11764
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 10/11/90.
Name Of Owner JAHN, EDGAR A.
Mailing Address 1 P. O. BOX 466
City St Zip MATTITUCK NY 11952
Property Address 1 595 HOLBROOK LANE
City St Zip MATTITUCK NY 11952
Tax Map No. section 113.00 block 6 lot 9.000
Cross Street YOUNGS RIGHT OF WAY
Building Permit Number Cross Reference:
Issue Date: 10/17/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
ink
•' 65C/
' M., '* :
0
, _
j „ty ,,_y� * * ye
„A .
w<i.-
3 r
a4tFdip,,,
r Town Hall, 53095 Main Road
BLDG.�3EPT.- �� "� '' / P.O. Box 1179
TOWN OF SOUTHOLD * ' :.
1� = A. ®i6 Southold, New York 11971
JUDITH T.TERRY `� „ oi,„0 TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Southold Town Code Enforcement Officer
From: Linda Cooper, Southold Town Clerk's Office
Dated: October 12, 1990
Transmitted herewith is a copy of application No. 669 for a Cesspool/
Septic Tank Construction Permit submitted by:
Rodick Construction Co. for Edgar A. Jahn .
Please review the application and location map and advise if the project
has received Suffolk County Health Department approval and if this office .-
may
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 X
DISAPPROVE
Comments: q„ cQ..x.c, QQ„ avN Oita sL JAA-
1aVIlea
....3"-'6.4111y, cist„_9..,_
Signature
Ai 1 t.:\ c:\ ®
Dated
;a s
OFFICE OF THE TOWN CLERK ,,,'"',,"'',
Town of Southold
Application No. 666
Judith T. Terry, Town Clerk ,��
Town Hall, 53095 Main Road ! Construction
P. 0. Box 1179 c mm ,
Southold, New York 11971 V) :_ ' � �` Alteration
Telephone 0,j- Qe $10.00 - Residential
(516) 765-1801 '..�
��' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. Cp Cp7
Fee $ (rj —
DATE /°7( 0'0
APPLICANT NAME: R f GSC CD K5 CO -
APPLICANT ADDRESS: j? O , ((7o f- 161 4-
SEPTIC °/ CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
/ LEM/ 6tiftel /4rpW1`LC_( tic
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: iDg1/4_ 1 /7 cI A1I, -(
OWNER MAILING ADDRESS: 0• (270(- 4 6c-
/
c'
,4 A-1- C-( tv c(C A.(. I I ( `� 5 v
OWNER PROPERTY ADDRESS: 5/ 3-- (a4. C F> a id
( - - [ ^il/crc
TELEPHONE NUMBER OF CONTACT PERSON: T zs S 4 4 d
TAX MAP NO. : Section 1 ( 3 Block Cep Lot
CROSS STREET: yo J 1, S 1- O C t-t/ A `--(
BUILDING PERMIT NUMBER CROSS REFERENCE:
• •
Signature of Applicant
RECEIVED BY:' i 1' - -
"> ItY F e n Clerk's Office -
DATE: OCT t 2 19 )
���N ✓ ��r� �` t x 5 -. '- , j• - I Lie
.; `\--'" 1 .• . _ _ _ - ' AT - , ST A t E
f7 ,r�� )i>' , • THE WATEiR Sup
^\ ,', II `, :rYtEP�IS FOR
;! \ <'',,.N �_•t �,, '`� N , ,Y, =. CONFORM �To
*_ ,� •\ \ 1� �' \ SUFFOLK ��.T.
\ \. , (5)
i �c � ' \ ' \ --...1.
/ � � ttyyy`� 'PLIC/
'
SUFFOLK
UFFO
LK , C
OU� - ,G
' �-, 3� SERVICES� ` 1 ' ,•„mit4 : ''� ' ,: ,:_ ;, G ,, � yam� � ==: CONSTRUCTION.\-7.----Nr; ' -0 -4' - , - +� DATE:' � r.-1 I•'=t U :t-f`.F :7i,9J H. 5. 2EF. NO.::,:.\ � , _ 0 y :: ,, . 0
\ .4„,..\\\. . f ' • � :
/ �T Q rP. ECCt{� _lJLY !c C APPROVED:_
/ '.r rrE�9
\`` ` `' ROD (,I< w�fsTi SUFFOLK CO.
�� t� 5'.� �, f�, -_ f1, • DIST. SE(
\4 .}} ' - k . , \, o 0� ,�, po . �dx �¢94 coo IT;
11144 595 HQ1..
\ 'l lis y .. .. ;y i
' y M(LLE(Z. P E OWNERS ADDRE:
N.
\ ,.0% \ \ \
\\
� �� •
29$---452-i', .
\� ' \ r: ^DEED: L. ?t7,6 •
\ ,\ f ^ TEST HOLE
\• \ PDX_ BUtt.t-rN�5 Frac =�;F!=. C4, _` , EXCAVATION II
\ • • ,het-.z.i.A!,--ciuQy.,E,,,y..,,, . , - . v o, ,:.- ' . SAt7 C t.C,o'�M �,
SEl�111GE - Hy e,
)<° FOLK C011NjY GEPI+R t?"Eta f ��fl+1 c �4 f' , ;��� . ... , aG.�,,+.;
J
FOZ P�PPRO •f..E OF ;Lf� ;� �20 •-•.i,,-..-..„,''' ;' .' r)
S €fie zIn"y fits to • ' °' � ' ,. =
rt. 1 11990 10;No. ;c0 15 '
4611-460-4 ,.... , " ,
, trIS.,..T.). 5/4-11.) .en:
[► - `1Qf\� 1 c .:T
--
APPROVEDOF TROVAL '' ,�f , ,. , p . •4;x`,; ••;,�:=.;,;s:•',:;!..r. � wAi t RSFRO� DA. � , ,• .,5;' _ - ,s,- ; ,.;- :`.-;:-:.''`r4;�`? '' IN PALE
_C PPE -r 5; L1F1RES O ' !of b. 1 .. - ;, `' .. :4-;'�,.' : ,, , - B�
• t. t a ;,•-' .`!.' .•A ``;'`::z .5' E, ..: . JUt4E-.I t r9�C
POrtrPleK VAN 75lvl
Dv- .,_.r._ • - -