HomeMy WebLinkAboutTuthill ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VIT.~LL STATISTICS
MARRIAGE OFFICER
RECORDS M~kNAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (63D 765-6145
Telephone ~631) 765~1800
southoldtown, nor t hfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO:
FROM:
DATED: June 16, 2005
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No.
Permit submitted by:
Southold Town Bufldihg Department
Linda J. Cooper, Southold Toxin Clerk s Office
3478 for a Cesspool/Septic Tank Construction
Catherine Mesiano for Tuthill c/o Wickham~ Bressler~ Gordon & Geasa
Please review the application and location map and advise if this office may issue the permit.
Please complete the form below and return it to me. Thank you.
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE J
DISAPPROVE
Comments:
Signature
Date~ ''~'~' ~-~0 0 j~
ELIZABETH A. NEVILLe.
TOWN CLERK
REGISTP~R 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
sout holdtown.northfork.net
OFFICE OF THE TOWN CI,ERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $10 or Non-Residential ~ $25 __
Septic Tank~ or Cesspool
Brief Description of Proposed Construction or Alteration
Application No.
Permit No.
Location of Proposed Construction/Alteration:
Owner of Property:
Owner Mailing Address: '~ ~)~
Owner Property Address
Name and phone number o£contact person C. ]f~.~.~. ~ '~' ~:~
Tax Map No: IO, O0 Section ~ 0 '~ Block '~- Lot
Cross Street
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
Signature of Applicant ' D'a~e
Received by: