HomeMy WebLinkAboutHill, Ronnie ELIZABETH A. NEVII,Llg,
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
~:~-~z~-~'gouthold Town
FROM:
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Building Department
Michelle L. Martocchia, Southold Town Clerk's Office
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
DATED: December 1, 2005
Cesspool Construction Application
Transmitted herewith is a copy of application No. 3547
Construction Permit submitted by:
for a Cesspool/Septic Tank
RLH Land Plannin~ Services Inc.
Please review the application and location map and advise if this office may issue the permit.
Please complete the form below and return it to me. Thank you.
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE ~
DISAPPROVE
Comments: ~~
Signature
Dated/'~'/O~
ELIZABETH A. NEVILLE"
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.nor~hfork.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 No3~ 7
r Permit No.
Applicant NameL'~ ~ '? _~.A.~ /~! ~
Applic~tM~ngAd~ess ~ ~ ~j ~ ~
S~tic T~ or Cesspool ~" -' ~ ~'- TM ' - -~ '
BfiefDesc~ptionpfProposedCons~ctionor~teration ~ ~g/~d
Location of Proposed
Owner of Proper,:
Owner Mailing Address:
OwnerPropertyAddress: ~--t/(~" ~0/f ~1/ ~0tot-'ff
N~e ~d phone nmber of con.ct pemon
T~MapNo: [~ S~tion 50 Block ~ ~t 10~
NOTE: LOCATION ~ ~ST B~S~ED ~H ~PLICATION. NEW
CONSTRUCTION ~Q~S S~ ~H ~fy D~T~ ~PROV~
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