HomeMy WebLinkAboutCorso, LouisELIZABETH A. NEVILLE, RMC, CMC
TOWN CLERK
M OF I~N l~'t~rt~x · ~C~ (~ ICIER
~'OW~ OF SOUII~t..~
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork, net
TO:
Southold Town Building Department
FROM:
Carol Hydell, Southold Town Clerk's Office
DATED: January 28, 2009
Transmitted herewith is a copy of application No. 3853
Permit submitted by:
for a Cesspool/Septic Tank Construction
Frank Notaro for Louis Corso
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.
I have reviewed the application and location map of the project cited above and make the following
recommendations: ~
APPROVE
DISAPPROVE
Comments:
Signature
Date~- /
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
'~Residential ~ $10 or [] Non-Residential ~ $25
Septic T~r Cesspool []
Application No. Permit No.
Applicant Name: ~"-~'~ ,. ~:
Applicant Mailing Address: ~.t~. ~-~ .
Brief. description of Pro sed
Location of Proposed Construction/Alteration:
Owner of Property:
Owner Mailing Address:
Property Address:
Name and Telephone No. of Contact Person: ~':~l · .~t~ ~. ~ ~ ~
I
Tax Map No.: Section: ~ ~ Block: ~i~' Lot: Il. I~
Nearest Cross Street: .'t~,.'t~, ~
SUBMITTED WITIt API~LICAIION. NEW[
NOTE: LOCATION MAP MUST BE
CONSTRUCTION REQIJIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL.
TEST HOLE
I OFFICE