HomeMy WebLinkAboutO'Hagan, James
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
~ECORDS MANAGEMENT OFFICER
I FREEDOM OFIN~I!ON OFFICER
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Town Hall, 53095 Main Road
P,O, Box 1179
Southold, New York 11971
Fax (631) 765.61415
Telephone (631) 7615-1800
southoldtown.northfork.net
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTH OLD
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TO:'--': -'::'S6~d Town Building Department
FROM:
Linda], Cooper, Southold Town Clerk's Office
DATED:
Transmitted herewith is a copy of application No. 3582
Alteration Permit submitted by:
for a Cesspool/Septic Tank Constmction or
James O'Hal!an
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], Cooper
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I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
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DISAPPROVE
Comments:
~~~~'~~~0~~-.
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Signature ~
~-;: ~e;oG
Date
. '
EUZABETH 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) 766-6145
Telephone (631) 765-1800
sou tholdtown, northfork,net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential@$lo_J or Non-Residential@$25_
Applicant Name j/'gvt,zJ Ol~
Applicant Mailing Address ~ 1- 2 '1 u TTI/t- AJriL.k... P few Y: . L.bv Ir.FI-
/'-'7/'(;[ IVIZLtL, IVY I( s & 'Z- /
Septic Tank v or Cesspool_ .
BrW Desc8Ption of Proposed Constmction or Alteration //Jf&t.J Z - ~ S,,"6<t
~{t.:; '~(Iszt4vT/Jtt.. ~oo/) .sa, Fr (),v I ~ pIJtl6fL 1'1/ o'<'-I,:;...r-
Location of Proposed Constmction! Alteration:
Owner of Property: v/tMI€J Oc~,
Owner Mailing Address:
Owner Property Address: / / 2J WI WbW~ fZ.o ~
O~ ~ NV II fiB 35'2--21313
Name and phone number of contact person ~ O~ C. '7/t- 4/B- 963i
Tax Map No: 1010 Section ,l{.- Block 0 z.. Lot.10. (
Cross Street 14/f-t/V {(,4/.J, 0/(14/1
-
NOTE: LOCATION MAP MUST BE SUBMHTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVE HE H DEPARTME PROV AL
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