HomeMy WebLinkAboutKrill, William OFFIC~ OF 1'I~ '[OWN
TO~¥N OF
m ;7,~BEFI] A. NnVILLB. TOWN CL~RK
P,O. BOX 1179
$OUTIIOLD. NI]W YORK 11971
Telephone
(631) 765-1800
TOWN OF SOUTIIOLD
Al'l'licatlol~ No. ~ ~Z/g:l~
CuHstructlol~ ~.f
Alteration
$10.OU - Heside~ltial ~
$25.00 -Non-P, esidential
SOUTIIOLD WAS'FEWA'I'EI~, DISPOSAL DIS I'RICT
APPLICATION
CONSTRUCTION or ALTEI(A'I'IUH I,I:-I~MIi
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
APPLICANT NAME:
APPLICANT ADDRESS:
PECOI'4 1C CESSPOOl,
P. O, IIOX 972
HAT'I'[TUCK, FIElV YORK 1952
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
.
OWNER OF PROPERTY:
OWNER MAILING ADDRESS;
LOCATION MAP: Must be attached hereto before I~,;r'niit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OP, ALTt. RATION:
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PEP, SON:
TAX MAP NO.: Section
CROSS STREET: '
BUILDING PERMIT NUMBER CP, OS5 I',EI:EI~
._Lot
ICI.
5igllature of
R~:CEIVED BY: ~,~
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
]FOUNDATION 2ND [ ] INSULATION
[ ]FRAMING _~_ F__INAL
[ ]FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
DATE
INSPECTOR '~'~' ~
WILLIAM KR£LL
3330 EUGENES ROAD
CUTCHOGUE