HomeMy WebLinkAboutKavanagh, Edward & Mary ELIZABETJ~ A. NEV~.L~
TOWN CLERK
REGISTRAI~ OF VITAL STATISTIC~
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATiON OFFICER
Town Hall, 53095 Main Road
P~O~ Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone ~631) 765-1800
southoldtown.nor thfork.net
TO'.'.
FROlgi:
DATED: April 15, 2004
Transmitted herewith is a copy of application No.
Permit submitted by:
Manzi Homes for Kavanagh
OFFICE OF ~ TOWN
~ ~ 5 ~ TOWN OF SOUTHOLD
S6~th61d To~Bitilding Department
Linda J. Cooper, Southold Town Clerk's Office
3306 for a Cesspool/Septic Tank Construction
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 pemfit.
Please complete the form below and return it to me.
Linda I. Cooper
I have reviewed (he application and location map of the project cited above and make the following
recommendations: ~
APPROVE
DISAPPROVE
Comments:
Date'~ "
OI~ICE OF 'rile ~fOWN CLERK
TOWN OF,SOUTIiOLD
~ELIZABE71~ A, NgVILLE, TOWN CLlgRK
P,O, BOX 1179
sOUIItOLD, NEW YORK 11971
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
Application No. '~3~)
Construction
Alteration
$10.00 - Residential
$25. O0 - Non-Residential
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE
APPLICANT NAME:'
APPLICANT ADDRESS: ~'~
SEPTICs/ CESSPOOL
DESCRiPTiON OF PROPOSED,,CONST. RU:CrFI¢
LOCATION MAP: Must be attached hereto
LOCATION OF PROPOSED CONSTRUCTION,OR,'Ai
OWNER OF PROPERTY:
OWNER MAILING ADDRESS;"~O
O
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO.: Section 1 ~ ~[. Block ~-~
cross STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
Lot g, 3
RECEIVED
DATE:
- $i9-natur~-of A~'~hc~ht
BY:
~/l~.' '~j~/n. Clerk's Office'
7Lz'S'T MOL~
U/VD
~: :~Map o£Desc~bed Propervj
:"i:!': :?: S~O.~ed at Mattituck
· o~ pfrSout~9!~{Suffolk County New York
"3Di~trie~1000 Section 141 Block 3 Lot 6.3
, -~7','/.,e , t: ".' :. =
SI.IFFOLK COUNTY DEPARTM~IT OF tlw..~LTH
pERlVlrl FOR gi~t'l~OV/,l~ OF CONSTRUCTION ~OR A \~I~GL~ F.4ahll~Y ~rD~E ONLY
FOR ~M~ OF~ BEDROOM~ ~THO~ ~RUZZO R.L. S
~Y AUTERA~ON OR ADDITION TO THIS M~ ]SA VIO~TION OF SECTION 72~
HIS P~CEL IS SUBJECT TO ~Y EASEMENTS OR ~ST~CT 0NS OF RECORD
~VATIONS ~FER TO THE ~VE EAST~N TO~S TOPOG~PHIC MAP