HomeMy WebLinkAboutO'Malley, James 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
TO:
FROM:
DATED:
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Southold Town Building Department
Linda J. Cooper, Southold Town Clerk's Office
Transmitted herewith is a copy of application No. 3405
Permit submitted by:
Douglas McGahan for James & Maura O'Malley
for a Cesspool/Septic 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 beloxv 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:
Signature
Dated
ELIZABETH A. NEV~.r .E
· -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 WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential ~ $10
Applicant Name
Applicant Mailing Address
'/V'or Non-Residential @ $25 __
Application No. ~ ',-10~.~
Permit No.
Septic Tank t.,~or Cesspool c/
Brief Description of Proposed Construction or Alteration
Location of Proposed Construction/Alteration:
Owner of Property: 'M~,o~
Owner Mailing Address: ~tZ b.~-~,.,,,
Owner Property Address:
N~e ~d phone n~ber of contact person
T~ Map No: ~ Section [,'¢ Block
Cross S~eet ." kC'~
NOTE: LOCATION ~ MUST BE SUB~TTED ~T~ ~PLICATION. NEW
co sxauCXlO oux s wxx xa nze mz x vaov
Si~ature of Applic~t Date
Received Cy: ~