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Home My WebLink AboutRogan O Jr ELIZABETH A.NEVILLE,MMCTown Hall,53095 Main Road TOWN CLERK P.O.Box 1179 C4 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS p ® Fax(631)765-6145 MARRIAGE OFFICER �� a��' Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER �1 www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER I OFFICE OF THE 'TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department AUG 2 2 2017 FROM: Sabrina Born, Southold Town Clerk's Office BUIELDING DLTTo DATED: August 22, 2017 TO ®F S® HOLD RE: Cesspool Construction Application Transmitted herewith is a copy of application No. 4508 for a Cesspool/Septic Tank Construction Permit submitted by: JNS Contracting for Tom Roaan Please review the application and location map and advise if this office may issue the permit. Please complete the form below and return it to me. Thank you. I I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE DISAPPROVE Comments: Final approval required from the Suffolk County Health Department Signature Dated 'rooffol/re ELIZABETH H Aa NEVILLE,MMC Town Hall,53095 Main Road TOWN CLERK P.O. Box 1179 co CA Southold,New York 11971 REGISTRAR OF VITAE.STATISTICS 0' Fax(631)765-6145 MARRIAGE OFFICER Telephone(631)765-1.800 RECORDS MANAGEMENT OFFICER www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER FFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Sabrina Born, Southold Town Clerk's Office DATED: August 22, 2017 RE: Cesspool Construction Application Transmitted herewith is a copy of application No. 4508 for a Cesspool/Septic Tank Construction Permit submitted by: JNS Contracting for Tom Rogan Please review the application and location map and advise if this office may issue the permit. Please complete the form below and return it to me. Thank you. I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE DISAPPROVE Comments: Final approval required from the Suffolk County Health Department Signature Dated A cl\11;11� ELIZABETH A. NEVILLE I, V, , Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 Southold, New York 11971- REGISTRAR 1971REGISTRAR OF VITAL STATISTICS Fax(631) 765-6145 MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER southoldtown.noi-thfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWA fER DISTRICT APPLICATION CONSTRUCTION or ALTS RATION PERMIT CESSPOOL or SEPTIC; TANK Residential oa $10__,.,,' or Non-Residential @$25 Application No. Permit No. 10--/3-00 JN o n4 Ap licant Mailing Address Septic Tank---,/-or Cesspool__ Brief Description ol"Proposed CoristrLlCt1011 or ........------ Location of Proposed Construction/Alteration: Owner of -------- Owner Mailing Address: Owner Property Name and phone number of contact person ,_8jcr, 1_7 0/ -----------_------- Tax Map No: loor) Section 98 Flock 0 Lot I'S , 3-4- Cross Street --T�4E ................ NOTE: LOCATION MAP MUST BE SUBMITTED WIT11 APPLICATiON, NEW CONSTRUCTION REQUIRES SURVE , WITHAEALTH DEPARTMENTAPPROVAI., Sign, at e of Applicant Date Received by: -P- -EM OF H C PROPOSED SYS, DETA-IL F J7 —IT 11, 1195 A�A,N T O'N N OSCU7 jU) -A, YCPi' SU;TOLK 41 S.C. 'AX NCOO88-06-3.37 SCA1.7 1 ........... 20�7 Ais 10. Z j T�, f ffCt tT4 k, -7' iF t 6 Nathan "f Corwin Ill Land Surveyor OF