Loading...
HomeMy WebLinkAboutPeconic Sign Company ELIZABETH A. NEVILLE Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 Southold, New York 11971 REGISTRAR OF VITAL STATISTICS F. ax (63~) 765-6145 - MARRIAGE OFFICER ' .......... RECORDS MANAGEMENT OFFICER Telephone (631) 765-1800 southoldtownmorthfork.net ~~ APPLICATION Permit No. Applicant Name ]"~'~'~ ~th,,vh~,~A- Applicant Mailing Address ~ 'k~ I/~'~ ~(~'~0\~vc)~. ~) .L.~.. !']Cq~%-~c~ Septic Tank or Cesspool~)~ Brief Description of Proposed Construction or Alteration Location of Proposed Construction/Alteration: Owner of Property: ~.~.~t'~ Owner Mailing Address: ~t-~ (~::~-' Owner Property Address: Name and phone number of contact person Tax Map No: Section Cross Street Block NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW Signatur~ ~'f Applicant Received by~ (9~9~~ HAP OF PROPERTY 8URVEYMD GEORGE H. ~ MADELIhIE L. HU '~