HomeMy WebLinkAboutPatane, AlfredoELIZABETH A. NEVILLE
TOWN CLERK
OFFICE OF TIlE TOW}4 CLERK
TO$¥~N OF SOUTIIOLD
Southold Town Building Departmcnt
Towel llaU, 53095 Main I~oad
P.O. Box 1179
Souihold, New York 11971
Fax (681) 766-6145
Telephon~ (631) 765-1800
FROM:
Linda J. Cooper, Southold Town Clerk's Ollice
DATED: May 21, 2004
Transmitted hereMth is a copy of application No. 3322 for a CesspooL/Septic Tmi Constmctioa
Pcrrait submitted by:
Alfredo Patane
Please revicw the applicatiol~ mad location map and advise if the prqjcct has received Suffolk County
Health Department approval and if'this oilicc nmy issue the p~nit.
Plea~se complete the form below and Return st to m .
Linda I. Cooper
I have reviewed the application and location mal) of the project cited above and make the following
APPROVE
DISAPPROVE
Signaturc
Dated
*¢~dt~ OF LOT ~5
~51TUAT~: EA~ST NIAI~.ION
TO.INN: ~5OUTHOL~
5U~ I OLK GOUNTT, I~
~o~o~9
XCAVATION INSPECTION REQUIRED
FOR 8ANFI'ARY
BY HF..<H DEPAR'rMENT
· ELIZABETH A. NEVilLE
TOWN CLERK
Town Ha]], 63095 Main Road
P.O. Box 1179
Soulhold, New York 11971
Fmx (681) 765-6145
Telephone (631) 765-1800
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or AI,TERAT1ON PERNHT
CESSPOOL or SEPTIC TANK
Residential ~ $10__ _ or Non-Residential @ $25
Applicant Name A1 fredo Patan~
Applicant Mailing Address_ 2804 Woods
0ceanside,
Septic Tank X or Cesspool x
Brief Description of Proposed Con~tmction or Alteration_
famitv house
Location of Proposed Construction/Alteration:
Owncr ofProperW: hlfredo and Josephine
Owncr Mailing Address: 2804 Woods Avenue
0~eanside, N.Y. 11572
OwnerProperiyAddrcs~: 4430 The Lon= Way
Eas% Marion, N~¥. 11939
.Name.andphonenuJnberofcontac£porson Alfredo Patane
'Fax Map No: Section 30 Block 2
Cross Street Shrand
NOTE: LOCATION MAP M'UST
,CONSTRUCTION REQUIRES SUR~[
Sign~t~
Received l~y: t{ ;/~ _
Application No. ~3~ ~
Permit No.
N.Y. 11572
Cons~rucgion of single
(516) 678-8338
Lot 93
~BMITTED tWITH APPLICATION. NEW
.PP /