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HomeMy WebLinkAboutPumillo, JodyTOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ ] INSULATION ~.~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: ELIZABETH A. NEVILLE TOWN CLERK REGISTRAH OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFOKMATION OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 705-6145 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 ? /ll/~ , Applicant Name ~,-]C ~h Applicant Mailing Address Non-Residential ~ $25 __ Application No. 3<~(~ Permit No. Septic Tank or Cesspool ~ ,,/ BnefDescnptmn of Proposed Construgtion or Alteration ~~ ~cation of Proposed Con~tmctig~Alt~ration:} Ownerofmrope~¥1/C d007 /~/ ~ Owner Mailing Ad.ess: /OeP 0 ~C Owner Prope~y Address: /0q?O ~ Nme and phone number of contact person ~ Tax Map No: Section / ~3 Block Cross S~eet ~ ~o~: ~ocn~o~ ~AV ~US~ ~ SU~I~X~ w~m ~mCA~IO~. ~W CO~S~UCXIO~ ~UI~S S~~m.~ . si~c of ~Ni~t Received b~~ ~//o