HomeMy WebLinkAboutSanford, Linda ELIZABETH A. NEVILLE
T O'~rN CLERK
REGISTRAR OF VITAL STATISTICS
MAllRIAGE OFFICER
RECORDS M-iNAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
To~m Hall, 53095 Main Road
P.O_ Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldt own.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO:
FROM:..
Southold Town Building DeparUnent
Linda I. Cooper, Southold Town Clerk's Office
DATED: October 5, 2004
Transmitted herewith is a copy of application No. 3381 for a Cesspool/Septic Tank Construction
Permit submitted by:
Napoli for Linda Sanford
Please review the application and location map and advise if thc project'has received Suffolk Cotmty
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 loc,~on map of the project cited above and make the following
recommendations: I J
APPROVE ~'
DISAPPROVE
Comments:
Dated
ELIZABETH A. NEVII,LE
TOWN CLERK
REGISTB. AR OF VITAL STATIS'IICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFOILMATION OFFICER
OFFICE OF THE TOWN CT,~,RK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
To~m Hall, 53095 Main Road
P.O. Box 1179
Sou~hold, New York 11971
Fax (631) 765-6145
Telephone (631) 76511800
southoldtown.noffchfork,nel
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $10 Jot Non-Residential ~ $25 __
Application
Permit No.
Sepficr~orCesspool ~ ~o~ fl ~ ,- ' 0 ~ ~ /~
Brief D~cfipfion ofPropos~ Co~tion or Alteration
-~-t-'~' ~ '~'~ ~ ~ t ~
~ca~on of Propos~ Cons~ctio~terafion:
erM gAd ess:
Nme ~d phone nmber ofcon~t pe~on
T~MapNo: S~fion 0; Block 05 ~t g~- I
NOTE: LOCATION ~ ~ST BE S~M~ED WIT~ ~PLICA~ON.
Si~ Dat~
R~iwd g
NEW