HomeMy WebLinkAboutTorelli, Joe ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICE~
,~ ~ : OFFICE OF THE TOWN CLERK
TO: Southold Town Building Department
FROM:
Linda J. Cooper, Southold Town Clerk's Office
DATED: March 30, 2004
Town Hail, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
Transmitted herewith is a copy of application No. 3298
Permit submitted by:
for a Cesspool/Septic Tank ALTERATION
Morris Cesspool for Joe Torelli
Please review the application and location map and advise if the project has received Suffolk County
Health Department approval and if this office may issue the permit.
Please complete the form below and return it to me.
I have reviewed the application and location map of the project cited above and make the following
recommendations: ~
APPROVE
DISAPPROVE
Comments: Maintain required setbacks from adjacent wells, buildings, property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED.
Dated
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFOI~I~/ATION OFFICER
~, ~'~,~ ,~ _ ~' _.~/~FFICE OF THE TOWN CLERK
' ,-r
'~ ~' APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Town Hall, 53095 Main Road
P.O. Box 1179
South?Id, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
Residential ~ $10
or Non-Residential ~ $25 __
Application No. '-~
Permit No.
Applicant Name t/~O~r(,.5
Applic~t Mailing Address
S~tic T~ or Cesspool
Brief Descfiptio~ ~ Proposed Const~ction or Alteration
Location of Proposed Construction/Alteration:
Owner of Property: .~d-~-
Owner Mailing Address: /,-q~3'-
Owner Property Address:
Name and phone number of contact person
Tax Map No: Section
Cross Street f~
Block
Lot 27
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
p Date
Received I~y: Z ~