HomeMy WebLinkAboutMcCaffery, John E~[ZABETH A.~-EVILLE -
TOwN CLERK
REGISTi~R OF VITAL STATISTICS
MARRLKGE OFFICER
· RECORDS i~LkNAC~FAVIENT OFFICER
FREEDOM OF LNFOP~kTION OFFICER
JUL § ~3(~. ..:.
TO}' ' :'~ %-' ' ' ' ' *
.--. i - :..Soathold To~m Bmlding Dep~ment
Linda J. Cooper, Southold Tox~ Cl~k's Office
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldlown.nort hfork.net
DATED: July 16, 2004
Transmitted herewith is a copy of application No.
Permit submitted by:
3350
for a Cesspool/Septic Tank Construction.
John M'cCaffery
Please review the application and location map and advise if the project has received Suffolk County
Health Department a. pproval and if this office may issue the permit.
Please complete the form below and return it to me.
Linda J. Cooper
I have reviewed the application and location map of the project cited above and make thc following
reconunendations:
.
APPROVE
DISAPPROVE
Comments:
Signature
Dated
ELIZABETH A. NEV~ .t ,E
TOV~N CT,F;R~
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS 1ViANAGEMENT OFFICER
· FR~:uOM OF INFORMATION OFFICER
Town Hall, 5'309§ Main' Road
P.O. Box 1179
Southold, New York 11971
Fax (6~1) 765-6145
· Telephone (631) 765-1800
s outholc~own.nor thfork.net
OFFICE OF TH-II TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION er ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential ~ $10~ or Non-Residential ~ $25 __
ApplicautMailingAddress f'~D ?Po~J~&J
Septic Tank I or Cesspool~
Brief Description of Propos~ or Alteration
Location of Proposed Constmction/Alteration:/,~
^p .ca. on o. 3550
Permit No.
! 1'7/Y
Name and phone number of contact person
Tax Map No://9~) ~ection ~"-¢ ~llock d7 Lot ! [
NOTE: LOCATION ~ ~IUST BE/SUBMITtED WITH APPLICATION. NEW
~gnamre ofApplican¥ - / Date
Received