HomeMy WebLinkAboutMcGrath, Elizabeth ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
IvIARRIAGE OFFICER
RECORDS 1ViAIqAGERfENT OFFICER
FREEDOM OF INFO_,BeLfrY. · TJd~N OFPICER
' ' OFFICE OF THE TOWN CLERK
· j~J~_ [ 9 '~O'31 [~' TOWN OF SOUTHOLD
:~~e~td~'T~x~m Bmlding Department
FROM: Linda J. Cooper, Sonthold Town Clerk's Office
Town Hall, 53095 Main Road-
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
sour holdtown-nor thfork.net
DATED: July 16, 2004
Transmitted herewith is a copy of application No. 3349 for a Cesspool/Septic Tank Construction
Permit submitted by:
EliZabeth Mc Grath
Please review the appl/cation and location map and advise if the project has received Suffolk County
H~alth Department approval and if this office may issue the permit.
Please complete the form below and return it to me.
Linda J_ Cooper
I have rev/ewed the application and location map of the project cited above and make the following
recommendations:
.
APPROVE
DISAPPROVE
Comments:
Signature
Dated
ELIZABETH A~ NI~VIIJ,E
TOI~N CLERK
REGIST~ OF ~T~ STATISTICS
~GE O~CER
~?:~CO~S ~AGE~ OFFIC~
~F~DOM OF ~FO~TION OF~CER
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 766-1800
southoldtown,nor~hfork.net
OFFICE OF TIlE TOWN CLERK
TOWN OF SOUTHOLD
soUTHOLD WASTEWATER DISTRICT
APPLICATION
Residential ~ $10
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Non-Residential ~ $25 __
Application N-o~
Permit No.
Location of Proposed Construction/Alteration:
Owner of Property:
Owner Mailing Address:
Owner Property Address:
Name and phone number of contact person
Tax Map No: Section [ (~) t~
Cross Street J~t?~ ~ ~
Block Lot
y. zz?
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. · NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
Received I~y:
N/o/F MARK V. RiGKABALIGH
TERESKO
N/O/F wALTER
'OLE
ro THIS SURVEY IS A VIOLA TION
~ORK ETA TE EDUCATION LA
- SUBDIVISION 2. ALL CERTIFICA TIONS
~P ,~ND COP/ES THEREOF ONL Y IF
IMPRESSED SEAL OF THE SURVEYOR
~EON.
SAID LAW TERM "AL TERED BY"
L SURVEYORS UTILIZING ,~ COPY
'['~RMS EL/CH "INSPEC TED "AND
NOT IN COMPLIANCE ~"~TH THE' LAW.
SURVEY OF PROPERTY
A'T CUTCHOGUE
TOWN'OF SOUTHOLD
SUFFOLK COUNTY, N Y.
1000 - 109 - 07- 5.2
Scale: 1" = 40'
Feb. 17, 2004
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