HomeMy WebLinkAboutCocheo, Anthony ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
: ~'~ Southold Town Building Department
F~ROM: Linda J. Coo~er, Southold Town Clerk's Office
DATED: October 22, 2004
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No.
Permit submitted by:
3388 for a Cesspool/Septic Tank Construction
Zoumas Contracting Corp. for Anthony * Louise Cocheo
Please review the application and location map and advise if this office may issue the permit.
Please complete the form below and return it to me. Thank you.
I have reviewed the application and location map of thc project cited above and make the following
recommendations: ~
APPROVE
DISAPPROVE
Comments:
Signature
ELIZABETH A. NEVTT~T.I~.
TOWN CLERK
REGISTRAR OF ~iTAL STATISTICS
MARRL~GE OFFICER
RECORDS MANAGEMEN~ OFFICER
FREEDOM OF L~FO~L~TION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
· · P.O. Box 1179
Southold, New York 71971
' Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
Residential ~ $10.7~_
'CESSPOOL or SEPTIC TANK
or Non-Residential ~ $25 ........
Application l~..3~
Permit No.
Applicant Name
Applicant Mailing Address
Septic Tank or Cesspool__~_ . ,.. _ oj
Brief Description of Proposed Construction or Alteration
Location of Proposed Construction/Alteration:
Owner of Property:
Owner Mailing Address:.~_/~.~_
Owner Propeak~ Address:~
Name and phone number of contact person '~l~ o ~. N,c~
Tax Map No: Section ~ ~. Block ~ Lot
Cross Street ~
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVE/~Y WITH ~:I~TH DEPARTMENT APPROVAL
III