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HomeMy WebLinkAboutMagill, AlfredTown Ha~l, 53095 Main Road P.O. Box 1179 $outhold, New York 11971 Fax (881) 765-5145 Telephone (661) 755-1800 southold~o~.no~ork.ne~ OFFICE OF TOWN TO: FROM: Southold Town Building Department Linda Y. Cooper, Southotd Town Clerk's Office DATED: May 5, 2004 Transmkted hereMth is a copy of application No. 33115 Permit subm~Vced by: for a Cesspool/Septic Tank Construction Alfred Magill Please rev4ew the application and location map and advise if the project has received Suffolk County Health Department approval and if tiffs office may issue the pennit. Please complete the form below and return it to me. Linda J. Cooper have rev{ewed the application a~d location map of the project cited above and make the following recommendations: APPROVE DISAPPROVE Signature Dated ~©WN CLE~ R~S~ OF ~T~ S~AT~S~CS ~R~GE OFFICER RECO~S ~AGEMENT OFFICER FREEDOM OF INFO~TION OFFICER Town Hail, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (531) 765-6145 Telephone (631) 765-1809 sou~holdtowm.norihfork.not OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD S©UTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCT[ON or ALTE~ATION PERMIT CESSPOOL or SEPTIC TANK Residential ~ $10 iJ or Non-Residential ~ $25 __ Applicafion No3'~ {-~ Permit No. Applicant Name Applicant MMi/ng Address Septie Tank ~Cesspool / Brief Description of Proposed Construction or Alteration Location of Proposed Construction/Alteration: O~vner of Property: ~}~/~d'-~ ~? Owner Mailing Address: ~7'~ ~ Owner Property Address: Name and phone number of contact person Tax Map No: Section /~ ~ Block o ?' Lot TF~ Cross Street ~C~7--72-~' .//~'~F:~ ~'~ V ~ NOTE: LOCATION 1M[AP ~ST BE S~TTED ~H ~PL~CAT~ON. NEW CONSTRUCTION ~QU~S S~Y ~TH ~ D~P~T~NT ~PROV~ S~a~e of AppHc~t Date Received by: ,% vACANT ~oT 100.0' 56.9 60.11'