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HomeMy WebLinkAboutCollins, Richard ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MAHRIAGE OFFICER RECORDS MANAGEMENT OFFICER ~ ~ f - ----- . ',/~ 1~)FFICE OF THE TOWN CLERK ~ , ~ ~[ TOWN OFSOUTHOLD TO: ~dmg Department FROM: Linda J. Cooper, Southold Town Clerk's Office 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 DATED: April 14, 2005 Transmitted herewith is a copy of application No. 3451 for a Cesspool/Septic Tank Construction Permit submitted by: Donald Feller 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: ELIZABETH A. NEVILLF. 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 Residential ~ $10 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK __ or Non-Residential ~ $25 __ Applicant Name~ Applicant Mailing Address Septic Tank_~or Cesspool Brief Description of Proposed Construction or Alteration Application No.~q J I Permit No. Location of Proposed Construction/Alteration: Owner of Property: ~[~[ CI,.~-~?'v~ ~------~> Owner Mailing Address: ~:~ I ~ Owner Property Address: Block ~ Lot ~ Name and phone number of contact person Tax Map No: Section Cross Street ."'~t2'~, NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW Received by: