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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 ~SOt ! 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~ ? / . II