HomeMy WebLinkAboutLoughlan, KatherineELIZABETH A. NEVII,LE, RMC, CMC
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: ~. ~S~Utl~Ot&~...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: November 25, 2008
Transmitted herewith is a copy of application No. 3841 for a Cesspool/Septic Tank Construction
Permit submitted by:
Rich Bosworth~ Olde Towne Builders. For Katherine Loughran
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 remm 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 J
DISAPPROVE
Comments:
Signature
Dated
ELIZABETH A, NEVILLE --
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
.~Town Hall, 63095 Man
P.O, Box 1179
Southold, NewYork 1197
Fax (631) 765-0145
Telephone (631)
sou/holdtown.northfork.ne
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTEIL~TION PERMIT
CESSPOOL or SEPTIC TANK
Residential
Applicant Namc .~
Pcrl~lil No
Septic q'anl.: ~ o~ Cesspool
Brief Description of I'mposed
l~cation of Proposed Constructio~ff~teration:
Owllcr of Property:
Ox~ler Mailhlg Address:
Owner l'rope~ly Address:
Name and phone number of contact person (~to-~¢
Tax Map No: Section /
Cross StI'eel _ ~-~'
NOTE: LOCATION MAP M-UST BE SUBMITTED WlTIt APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
Receive<t t~y: ~L
Signature of
/ Dat~
:.~0.