HomeMy WebLinkAboutSuspenski, Stephen ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS 1VL~LNAGEMENT 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
): ~" 'd" ~'6'ffPdo3d~w uilding
FROM:
' ' OFFICE OF THE TOWN CLERK
TOWN OF SOUTttOLD
Department
Linda J. Cooper, Southold Town Clerk's Office
DATED:
Transmitted herewith is a copy of application No. 3494
Permit submitted by:
for a Cesspool/Septic Tank Construction
Courtnev Gallagher
Please review the application and locatiou map and advise if the project has received Suffolk County
Health Department approval and if this office may issue the permit.
Please complete the fom~ 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:
Dated
ELIZABETH A. NEVILLE '~
TOWI~ 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) 765-8145
Telephone (631) 765-1800
southo]dtown.nor~hfork.net
OFFICE OF THE TOWN CLERK
TOWN OF $OUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERIl{IT
CESSPOOL or SEPTIC TANK
Residential ~ $10_/ or Non-Residential ~ $25 __
Applicant Name ~ Ot,~f'~ e
Applicant Mailing Address {O0
^rplication ~o.Q$4q0t
Permit No.
Septic Tank ¥or Cesspool
Brief Description of Proposed Construction or Alteration ~-'~¥~cc"~(w-~.~
Location of Proposed Construction/Alteration: Owner of Property: 5 ifc ['3~),Ch
Owner Mailing Addross: %x..~ ~)~Lc~h~
T~ Map No: tO(Y~g~ction 'f ~ mock C~
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SU~,VI~ v~Trl~J.,T~.~EPARTMENT ~/~PRgVAL
,...~ature ~Applic-a~