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HomeMy WebLinkAboutAnemoyanis, Vivian TOWN CLERK REGISTF,~,.R OF VITAL STATISTICS RL~RL~GE OFFICER ,,.'.- t .i OFFICE OF TIqrF. TOWN CLERK TOWN OF SOUTI-IOLD Town Hall, 53095 MR~n Road P.O. Box 1179 Southold~ New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 sou~holc~town.northfork.net TO: FROM: DATED: Augnst 3 I, 2004 Trmxsmitted herewith is a copy of application No. Permit submitted bT. Vivian Anemoyanis Somhold Town Build'rog Department Linda J. Cooper, Somhold Town Clerk's Office 3370 for a Cesspool/Septic Tank Construction Please review the application and location map and adxdse if the project has received Suffolk Cmmty Health Department approval and if this office may issue the pem~it_ Please complete the form below mhd return it to me. Linda J. Cooper I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE / DISAPPR.OVE Comments: D~ted ~ ELIZABETH A. NEVILLE REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER I{ECOP~S/VLaNAGEMENT OFFICER FREEDOM. OF INFOP~ATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD %VASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Town H~ll, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6146 Telephone (631) 765-1600 sot/tholdtowamnortlffork.net Residential ~ $10 or Non-Residential C~ $25 __ Application No. -~ ~ 70 Permit No. Applicant Name ':,./i ~/iO ~ ~//~ ~ "0--~"'~ 0 '4 ~ Septic Tank /or Cesspool~ ' Brief Description of.l~roposed Construction or Alteration /]J~/~ [ O~ ! Location of Proposed Con~tmction/Alteration: O~erMallingAd~ess: .~ q 5 /~., ( XOS~ ~ y/~ ' , Nme ~d phone number of contact person U ' z~p~o:j~ s~io~ ~) ~o~ ~ rot~ NOTE: LOCA~N ~ MUST BE SUBmiTTED ~TH ~PLICATION. NEW 'CONSTRUCTION ~Q~S SURLY ~TH HE~T~ DEP~T~NT ~PROV~ gi~ of X¢~ ~at~