HomeMy WebLinkAboutNesin, Elaine ELilgABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
TOWN OF SOUTHOLD
TO: Southold To~vn Building Department
FROM:
Linda J. Cooper, Southold Town Clerk's Office
DATED: March 23, 2004
Transmitted herewith is a copy of application No. 3295
Permit submitted by:
Richard Saetta for Elaine Nesin
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
for a Cesspool/Septic Tank Construction
Please review the application and location map and advise if the project has received Suffolk County
Health Departmevt approval and if this office may issue the permit.
Please comple'e the form below and return it to me.
Linda J. Cooper
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE J
DISAPPROVE
Comments:
Signature
Dated
TOWN OF SOUTHOLD
P.O. BOX i 179
$OUTHOLD, ~rj~w yORK ! 1971
Telephone
Application No.
Construction
Alterat. ion
$10.00 - Residehtlal
$25.00 - Non-Resident/al
(63-~) 765-1800.~
~~~,~S TOWN OF SOUTHOL. D
· ' OUtNOLD WASTEWATER DISPOSAL DISTRICT
,~:~~ APPLICATION '
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
DATE
Iq. 2004
APPLICANT NAME: R~,.h~.-a g,~,.rr~
APPLICANT ADDRESS:. iP- n g.T 9flA7: P.~-p*npnrr_- NY
SEPTIC ~ CESSPOOL
DESCRIPTION OF PROPOSED~ CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ,ALTERATION: OWNER OF PROPERTY: ~,~o~,.,o
OWNER MAILING ADDRESS: 32
l~g7n
OWNER PROPERTY ADDRESS:
gull Pond Lane (East S~de)
Greenport~ Ne~ york 11944
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO.: Section ~ Block 04
CROSS STREET: ~---~, ~. q F
%
/7own Clerk's Office
Rich Saetta 63!-765-4900
Lot 7,4 ~ 28,22
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant