HomeMy WebLinkAboutCatapano, Karen ~I'.IZABI~T.H ~ NE'VH.L~
TOWN
REGISTRAR OF VITAL STATISTICS
MARRIA(~E OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFO R~VIA~TION. OFYICER
OFFICE OF THE TOWN CLERK
TOVq-N OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
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FROM:
Linda J. Cooper, Southold Town Clerk's Office
DATED: April 14, 2004
Transmitted herewith is a copy of application No. 3305
Permit submitted by:
for a Cesspool/Septic Tank ALTERATION
Peconic Cesspool for Karen Catapano
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 remm it to me.
I have reviewed the application and location map of the project cited above and make the following
recommcmdationS:APPROVE /
DISAPPROVE
Comments:
Maintain required setbacks from adjacent wells, buildings, property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED.
Signature
KAREN CATAPANO
3985 SOUND AVS~JE
offlc~ oF ~ 'I'owN CLI~RK
TOv~q O1~ SOU'I1tOLD
PI .17~B~ A. NBVILLE. TOWN CLERK
P,o~ BOX
SOUTHOLD, N~W ¥oi~K
Telephone
(63t) 765-1800
Application No~
~Co~?trt!ct}o~ ~
$10.00 - ]~eside,,t;al ~
$25.00 - Non-Residential ....
.OWN, OF SOUTHOLD
WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee '$
APPLICANT NAME:
PECONIC
DATE
CESSPOOL
APPLICANT ADDRESS:, v. o. BOX 972
MATTITUCK, NEW YORK 11952'
SEPTIC CESSPOOL /-'"'
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATIONiOE PROPOSED CONSTRUCTION OR ,ALTERATION: · OWNER OF PROPERTY: ,~'-.~-~.~-'~
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO.: Section B~ock Lot
/ / Town Glerk's
· -- 5igna~ant
Office