HomeMy WebLinkAboutPerrone, Frank ELIZABETH A. NEV~L~
TOWN CLERK
REGISTRAR 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
southoldtown.northfork.net
TO:
FROM:
DATED:
Southold Town Building Department
Linda J. Cooper, Southold Town Clerk's Office
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
July 13, 2005
Transmitted herewith is a copy of application No. 3488 for a Cesspool/Septic Tank Construction
Permit submitted by:
Frank & Patricia Perrone
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
REGISTRAR OF VITAL STATISTICS
MmUUAOE OFFfCER
RECORDS M~NAOEM~NT
FREEDOM OF INFORMATION OFFICER
.~Town Hall, 53095 Main Roa
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone '(681) 765-1800
southqldtown.northfork.ne'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential ~ $10/or Non-Residential ~ $25 __
Applicant Name ~'~::~ ~ ~:~ ~,~c~/ ~ 4 r~ ~__ ! ~
Application No. ~/~
Permit No.
Name and phone number of contact person
Tax Map No: Section / ~
Block -C t
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
Received gy:
Date
Signature of Appli~arit