HomeMy WebLinkAboutManzi ELIZABETH A. NEVILLE
TOWN CLERK
REGISTB. AR 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
TO: Sout.hold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: October 29, 2004
Transmitted herewith is a copy of application No. 3391
Permit submitted by:
for a Cesspool/Septic Tank Construction
Manzi Homes, Inc.
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 reviewed the application and location map of the project cited above and make the following
recommendations: ~
APPROVE
DISAPPROVE
Comments:
Dated
OFFICE OF 'rile "fOWN CLERK
TOWN OFSOUTIIOLD
ELIZABETlt A. NEVILLE, TOWN CLgRK
P.O, BOX 1179
SOUTHOLD, NEW YORK 11971
Telephone
(516) 765-1801
Application No.~Ot(
Construction
Alteration
$10.00 -Residential ~,
$25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee ~
APPLICANT NAME:., ~'"~(~'~
APPLICANT ADDRESS:.
SEPTIC ~'~CESSPOOL
DE. SCRIPT tON OF PROPOSED CONSTRUCT!QI
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ~J~,c~_~, ('~T)r'~rle~-
OWNER MAILING ADDRESS:~.~ ~
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO.: Section /0 6 Block 6 Lot,
caoss s, aa,:
BUILD'lNG PERMIT NUMBER GROSS REFERENCE:
RECEIVED BY:
DATE;
(O.i: 'T~wn Clerk's Office
k
_-7 ,.00 ~/o0 -