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HomeMy WebLinkAboutVerity, Michael ELIZABETH A. NEVILLE TOV~N CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGE M EI~OI~R , ~,, ~ ~ · ~)FFICE OF THE TOWN CLERK ~ ~ °~- _~._~ ' \ TOWN OF SOUTHOLD TO: L..~-.'"'~Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: July 11, 2005 Transmitted herewith is a copy of application No. Permit submitted by: Michael Verity Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax ~631) 765-6145 Telephone (631) 765-1800 southoldtown.nort h fork.net 3487 for a Cesspool/Septic Tank Construction 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 reviewed the application and location map of the project cited above and make the following recommendations: APPROVE DISAPPROVE Comments: ~ignature ELIZABETH A. NEVILLE " TOWN CLERK REGISTHAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFO1LMATION OFFICER · ~Town Hall, 53095 Main Road P.O. Box 1179 Southold, New Yerk [1971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential ~ $I0 o~r Non-Residential ~ $25 __ Application No~ ~/7 Permit No. Applicant Name~ ~~ ~,//a/ling Address ~.~, ~ Brief Desc, ription of Proposed Construction or Alteration Location of Proposed Construction/Alteration: Owner Mailing Address~ Owner ., · _ Property Address: Name and phone number of contact person Tax Map No: _ Section 3~"-- ~ -Block._~_____ Lot NOTE: LOCATION MAP MUST BE SUBMITrED WITR APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WlTlt I~EALTH DEPARTMENT APPROVAL . Received IJy: 0'~o~ ~?~W \ \ \ \ \ \ \ \ 0 o :$3.LON )t~Ok ~3N 40 kN¥cll~O9 3~NY~$NI 3'IJ.U. ONV"~ 3J.I~3A 'P '13VHOII~I L6g-~o0~ :ON 80r ~o0: 'i,t 'AON :3J. VO gO0~ '§L VIVO 3~OH IS3J.