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: