HomeMy WebLinkAboutVentura, Arthur & Ruth ELIZABETH A. NEVILLE
TOWN CLEHK
REGISTP. AR OF VITAL STATISTICS
MAHH[AGE OFFICER
. H.ECORDS MANAGEMENT OFFICER
FREEDOM OF INFOHI~IATION OiVFICEP~
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Southold Town Building Depafanent
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York ~1971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtovrnanorflffork.net
FROM:
Linda J. Cooper, Southold Toxxm Clerk's Office
DATED: June l, 2004
Transmitted herex~fth is a copy of application No. 3324 for a Cesspool/Septic Tmlk Construction
Permit submitted by:
Arthur & Ruth Ventura
Please review the application and location map and adxdse 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 reviewed the application and location map of the project cited above and make the following
recommendations,: ~
APPROVE
DISAPPROVE
C o mment s:
D~ted t~
ELIZABETH .a~ NEV~,I,~,
TOWN CLF_zH_K
REGISTHAR OF VITAL STATISTICS
MARRIAGE OFFICEt~
RECORDS MANAOEM~qT OFFICER
· ~/IEED OM .O F INFOpAVIATION' OFFIC ER
OFFICE OF TI-IE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD ~VASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PER~HT
CESSPOOL or SEPTIC TANK
Residential ~ $10 or Non-Residential @ $25 __
Applicant Mailing Address
Town Hall, 53095 Main Road
P.O. Box 1179
Sou[hold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
s outholdtowmnor~tdorl~ne~
Application No~ ~
Permit No.
S~tic Tank or.Cesspool
Brief Description of Proposed Consmtction or Alteration
Location of Proposed Construction/Alteration:
Owner ofPropcrty: ~]~ ~ ~rT~l~r
Owner Mailing Address: ~-q
Owner Property Address: -.~Jl/i,~
Name and phone number of conutct person ~..~ t ~'~ Lie e¢
T~ ~p No:/~ Section /$- - Block
NOTE: LOCA~ON ~ ~ST BE S~TTED I~ ~PLICATION. ~W
CONSTRUC~ON ~Q~S S~ ~H ~TH~EP~NT ~PROV~
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Received l~y:
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