HomeMy WebLinkAboutTorkelson Builders ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
~E E I)Ot~ GF-i NL~U~--O~h-O--~FF iCE R
Z 2[I]5 orrICl~ OF THE TOWN CLERK
~ ~ ! TOWN OF SOUTHOLD
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Soutbold Totem Building Department
Town tlall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
sour hotdtown.nort hfork, net
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: April 21, 2005
Transmitted herexvith is a copy of application No. 3461
Permit submitted by:
for a Cesspool/Septic Tank Construction
Torkelsen Builders~ lnc
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 reviexved the application and location map of the project cited above and make the following
recommendations: ~
APPROVE
DISAPPROVE
Dated
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
..,Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential ~ $10
__ or Non-Residential ~ $25 __
Application No .~0~.{'~
Permit No.
Applicant Name'~-t3E~6~J0~J ~o/~oerzJ ~
ApplicantMailingAddress ~O ~o~ l~?f' '..~Oc~'it~ol-t~ ~.¥.
Septic Tank I or Cesspool
Brief Description of Proposed Construction or Alteration
Location of Proposed Construction/Alteration:
Owner of Property ~0/--T~'~?L T5 ~/" ,t~'d-de'~'
Owner Mailing Address: ~oo ,..[u~ r~ ~-/~
Owner Property Address: ~oO
Name and phone number of contact person
T mpNo: So tion 7
Cross Street
NOTE: LOCA~ON ~ ~ST BE S~M~D ~H ~PLICA~ON. ~W
CONSTRUCTION ~Q~8 S~Y ~H ~TH DEP~ ~PROV~
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