HomeMy WebLinkAboutRoppelt, George & Veronica· -': ' ELIZABETH A. NEVH,!,E
TOWN CLERK
REGISTRAR OF VIT.~L STATISTICS
i~£4~1RIAGE OFFICER
RECORDS ~AGE~EN~ OFFICE/t
EREEDD/'~ _OF LNFOI~L~kTiON OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Town Hall, 53095 M~in Road
P.O_ Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southold~own.northfork.ne~
TO:
FROM:
DATED: June 4, 2004
Transmitted herewith is a copy of application No.
Permit submitted by:.
Zoumas Contractin~ for Roppelt
South_old Town Building Department
Linda J. Cooper, Southold Town Clerk's Office
3328 for a Cesspool/Septic Tank Construction
Please review the application and location map and advise if the project has received Suffolk County
Health 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 reviexved the application and location map of the project cited above and make the following
recommendations:
.
APPROVE
DISAPPROVE
Comments:
I
ELIZABETH A. N-~Irrr J,m
TO~ CLERK
REGISTRAR OF VITAL STATISTICS
NLA.Ri~.AGE OFFICER
RECORDS 1V~NA_GEME/~T OFFICER
FREEDOM OF'INFOR-WIATION' oF~I-CER
Town Hall, 53095 Maln Road
P,O. Box 1179
Southold, New York ~1971
· Fax (631) 765-6145
Telephone (631) 765-1800
sour holdtown.nort hfork.ne t
OFFICE OF THE TOW'N CLERK
TOVVN OF $OUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential ~ $10
__ or Non-Residential ~ $25 __
Application No.~ 7~g
Permit No.
Applicant Name
Applicant Mailing Address
ZOUMA8 CONTRACTING CORP.
POBox3el
Septic Tank ~ or Cesspool ~:~
Brief Description of Proposed Constraction or Alteration
Location of Proposed Construction/Alteration:
Ow'nerofProperty: ~.t.,l, (//~tt.~
Owner Mailing address: ~ .~.l/) At'~
Owner Proper~ Address: ]q4 ~; t. ~-~
Nane and phone number of contact person ~O B'''~
Tax Map No: Section 070 Block
Cross Street
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
Received by:~~ , '
~b
N
Oi ,OGI
]HOk~