HomeMy WebLinkAboutManos, Irene
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Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
OCT I 0 2"06
'; OFFICE OF THE TOWN CLERK
TOWN OF SOUTH OLD
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~2"~so'lil~ofd 1 owl Building Department
FROM:
Linda 1. Cooper, Southold Town Clerk's Office
DATED:
Transmitted herewith is a copy of application No. 3634 for a Cesspool/Septic Tank Construction or
Alteration Permit submitted by:
Patricia Moore
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
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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
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Comments: . ~~~ 1;4~~,~.e
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Dated /
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
Boutholdtown.northfork.net
. .
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $lO~ or Non-Residential @$25_
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APPlicationN~
Permit No.
Applicant Name Pc...fr~(t:i C 1l7f)~
Applicant Mailing Address 5l 07. (;) /170/ n' ~ t/O d
S~old /IAI /(171
Septic Tank_or Cesspool~
Brief~c~ption of Proposed Construction or Alteration
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Location of Proposed Construction/Alteration:
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Owner of Property: f1 N-<Y' MS
Owner Mailing Address:
Owner Property Address:
Name and phone number of contact person
Tax Map No: Section:3 <;
Cross Street
Block
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NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY.~ . ALTH DEPARTMENT APPROVAL
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Date
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