HomeMy WebLinkAboutLone, Ruth ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Building Department
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
FROM:
Linda J. Cooper, Southold Town Clerk's Office
DATED:
Transmitted herewith is a copy of application No. 3532 for a Cesspool/Septic Tank Construction
Permit submitted by:
Ruth Lone
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
/
Dated
OFFICE OF THE TOWN CLERK
Town of Southold
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 11971
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
Application
Construction
Alteration
$10.00 - Residential
$2'5.00 - Non-Residential
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee '$ ~
APPL'CANT NA
APPLICANT ADDRESS:
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
OWNER PROPERTY ADDRESS: L~Io~t'- ~)1~-~
OF'CO ACT Gbl'
TAX MAP NO.: Sect,o~.~ .Block ! .Lot
BUILDING P. ERMI;NUMBER~R~S REFE~CE:"
Signature of AppliCant
RECEIVED BY.'~. ~ ~-,
Town Clerk's Office
DATE: /OI ~ l~-~)~
~l"1 ,.kYM ~0 .L~ .~ dlNS~":INMo tO'~'0'6C
A~MHUIH
Et~3N tON3
X
dd
[ ,00 00~
· o::D puoqd~i¢J_ '~JoA m2N
:jo 61J2DJO-I JO moN pue-1
),bE I£Cj
/
/
Z:\Common\Current\Atb~!rtsonM~r,ne\C~wlx
.q
Jo ~N pu~
ALBERTSON
fda I N ROAD
$00 TktOL D, NY.
.RAN I YAt~Y .flYSTFkl S I TEPL AN
UJ
r~'~
_J
I I
Z
0
Z~- ~ ~_ Lu
~.< ~- <
LL ti t --
~ ~LUO COLuO
~-
ONo_ ~' ONnl--
a~tu,,~::t s~uoq.L IO~Ho~gl
:jo ~lJO~Jo.4 ao rnoN ~uD~