HomeMy WebLinkAboutMCM Homes Inc ELIZABETH A. NEVILLE
TOWN CLERK
I~EGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER ·
RECORES ~A~mE~T omCER
F~.n?~O~_U~ .oa~ T~O~ ~mCER ~.'
South616~
FROM:
OFFICE OF THE TOWN CLERK
ToWN OF souTHOLD
I~ Building Department
' e
Linda J. Cooper, Southold Town Clerk s Offic
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southaldtown.northfork-n~t .
DATED: January 12, 2005
Transmitted herewith is a copy of application No. _ 3423 _ for a Cesspool/Septic Tank Construction
Permit submitted by:
MCM Itomes 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 remm it to me.
Linda J. Cooper
[ have reviewed the application and location map of the project cited above and make the following
o
recommendations:
APPROVE ~ -
Comments:
DISAPPROVE ~
Signature
_
Dated
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFOR.MATION 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/ or Non-Residential ~ $25 __
Application No. ~b~ ~
Permit No.
Applicant Name 1%\~-}'~ ~;~o~v~--~ '~.~.
Applicant M~fing Address. ¢ C~ ~ ~ ~
S~tic T~ or ~sspool
Brief Description of ~opos~ Com~cfion or ~te~tion ~
Location of Proposed Construction/Alteration:
Owner of Property:. ~[vXf-- ~ ~o ~'~_..~
Owner Property Address: ~.~'~
Name and phone number of contact person ~.-~.-
Tax Map No: ]ooo Section *~0 Block C>'~ Lot
NOTE: LOCATION ~ MUST BE SUBMITTED WITH APPLICATION. NEW
u
._~
/ ,I
hi