HomeMy WebLinkAboutCedar Farm LLC x�,.yam
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ELIZABETH A.NEVILLE,MMC J�'am ' 2r ' Town Hall,53095 Main Road
TOWN CLERK ""T ,"' '� P.O.Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS t
�( Fax(631)765-6145
MARRIAGE OFFICER; g W CY {T Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER f "¢ www.southoldtow vgov
FREEDOM OF INFORMATION OFFICER e� "l
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Sabrina Bom,Southold Town Clerk's Office
DATED: May 16,2019
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4754 for a Cesspool/Septic Tank Construction
Permit submitted by:
Robert Wilson for Bich-Choc(Cedar Farm LLC).
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
4�,�gUFFpG.¢CaG
ELIZABETH A.NEVILLE aZ" y Town Hall,53095 Main Road
a ;� P.O.Be.1179
TOWN CLERK y $ Southold,New York 11971
REGISTRAR OF VITAL STATISTICS W m Fax(631)765-6745
MARRIAGE OFFICER pij. �'� Telephone(631)765-1800
RECO RDS MANAGEMENT OFFICER goutholdtnwn.northfork.net
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @$10 V or Non-Residential @$25_ Application No.
t
Permit No.
Applicant Name__......—..._. 11
— _......._..---.........—
Applicant Mailing Address_A E 5 _�P ;.��_
River �R,�f..... N_ t(qoE
Septic Tank_or Cesspool_
Brief Description of Proposed Construction or Alteration---, -,.. __...._
Location of Proposed Construction/Alteration:
Owner of Property:_0 -r kG c C.LCUKL�KLC 1�1.Ak",NYl, �..�..C-
Owner Mailing Address:.,,- --.. __1,J N Fi r�js
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Owner Property Address 01 r tx A, i�p
Name and phone number of contact person .................._ ___....—
Tax Map No:iGW Seet on
Cross
NOTESStreet
LOCATION P MUST BE SUBMITTED WITH APPLIC
ATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
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Date
S� ature of Applicant
Received by: -...—
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