HomeMy WebLinkAboutPappas, Theano.J
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
~_~.?~2~_~..¢iitfi~crl~d~_ o.wxt Building 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.northfork.net
DATED: May 24, 2005
Transmitted herewith is a copy of application No. 3471
Permit submitted by:
for a Cesspool/Septic Tank Construction
Robert Tast for Young &Young
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: ~..~
Signature
Dated
10/02 '05 TH[T 13:17 FAX 631 765 6145 S01JTIt0LD TOWN CLERK ~]002
~.t -~ ~I[I~TH A. TOWN
REGISTRAR OF VITAL STATISTIC~
MARItIAGE O='zriCER
RECORDS MANAGEMENT OFFICER
FREEDOM OF I~TFORMATION
Town Ir1.11; 53095 ~ 'Rom~
P.O. Box 1179
Southolc~ New York 11971
Fax (681) 765-6145
Telephone (631) 765-1800
southoldtowr~northfork.ne~
OFFICE OF '['HIll TOWN
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Permit No.
A.~Ucant Name~
Applicant Mailing Address~.
Septic Tank or Cesspool
BriefD.escfi~tion of. ?oposcd ,Co .ns~ tcfio, n or Altc~tion~
LocaQon of Proposed Consl~uclion/Akeration:
Owner Mailing Addmss:~
0whir l opony Mdr ss
Name and phone number of contact person
Tax Map No: Section ~ ~
Block t:~ ~ Lot ~¢', Z
NOTE: LOCATION MAP MUST,,~E SUI~i¥11'i-i*:D VffrH APPLICATION. NEW
CONSTRUCTION REQUIRES SUR~ ~ IIFALTH DEPARTMJgNT APPROVAL
$~natum of Applicant Date
Received
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