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Home My WebLink AboutBernhart, Sanford ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.nor thfork.net Southold Town Building Department Linda J. Cooper, Southold Toxvn Clerk's Office T_O;~ FROM: DATED: November 5, 2004 Transmitted herewith is a copy of application No. 3395 Permit submitted by: Spirit Building Corp for Sanford & Sarah Beruhart for a CesspoolJSeptic 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 reviewed the application and location map of file project cited above and make the folloxving recommendations: APPROVE k//'''/ DISAPPROVE Comments: ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS" MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT CONSTRUCTION or ALTERATION PERM[IT CESSPOOL or SEPTIC TANK Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.north£ork.net Residential ~ $10__ or Non-Residential ~ $25 __ Applicant Name ~-~' tO! d,"~- /.~cc, L/?? .¥ 7 Applioant Mailing Ad,ess ~O ~ ~/0 ~ Septic T~ ~ or Cesspool~ / B~f Descfigtion of Proposed Construction or Alteration Application No. d5~ 3~'-5''-'-- Permit No. f p' Location o osed Construction/Alteration: Owner of Property: , ~4 ~t//% Owner Mailing Address: ."}5',5-- Owner Property Address: Name and phone number of contact person /~, ~,//,~;o / g./?- gzz ~c/7z TaxMapNo: Section /~ Block O ~/ Lot ooe'd Cross Street ~cr~._/.~ ..;.~ ~ NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY~¥ITH.HEALT. H DEPARTMENT APPROVAL Signature of Applicant gate Received by: ,. ,-- =.