HomeMy WebLinkAboutBravo Contracting (2) ELIZABETH A. NEVrg,l,l~.
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hail, 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:
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Southold Toxvn Building Department
Linda J. Cooper, Southold Town Clerk's Office
September 22, 2005
Transmitted herewith is a copy of application No. 3515 for a Cesspool/Septic Tank Construction
Permit submitted by:
Bravo Contraetine (Lot//14)
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
Dated
EI,IZ&BETH A. NEVILLE ':'-
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS IvIANAOEMEIqT OFFICER
FREEDOM OF INFORMATION OFFICER
.~Town Hall, 53095 Msin Road
P,O. Box 1179
Southold, New York 11971
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 ~ $10 ~
__ or Non-Residential ~ $25 __
Application No.'?~/
Permit No.
Applicant Name
Applicant Mailing Address
Septic Tank or Cesspool
Brief Description of Proposed Construction or Alteration
Location of Proposed Construction/Alteration:
Owner of Property: ~ 0(3 6~ Id~'l~A
Owner Mailing Address: [~ - {~- ~-}t4,
Name and phone number of contact person
Tax Map No: Section ~ Block ~ Lot ~' 2 ~
CrossSt eet L 0ig{ LJA[3
NOTE: LOCATION ~ ~ST BE S~D ~H ~PLICA~ON. ~W
CONSTRUCTION ~Q~S S~Y ~ ~ DEP~~ ~PROV~
Silage of Applie~t Date
R~iv~ ~ ~
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