HomeMy WebLinkAboutPapazahariou, ZahariaELIZABETH A. NEVH J J~.; RMC, CMC
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
southoldtown.northfork.net
TO:
FROM:
DATED:
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Southold Town Building Department
Carol Hydell, Southold Town Clerk's Office
September 3, 2009
TOW, OF'SOLITi~OLO I
RE:
Cesspool Construction Application
Transmitted herewith is a copy of application No. ~
Permit submitted by:
Zaharia Papazahariou
for a Cesspool/Septic Tank Construction
Please review the application and location map and advise if this office may issue the permit.
Please complete the form below and return it to me. Thank you.
Carol Hydell
I have reviewed the application an~ocation map of the project cited above and make the following
recommendations: J
APPROVE
DISAPPROVE
Comments: Final approval required from the Suffolk County Health Deparhnent,
Signature
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
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 Non-Residential ~ $25
Application No.~ ~
Permit No.
Applicant Name
Septic Tanl~ or.Cesspool
Brief Description of~o~
Location of Proposed Construction/Alteration:
0wner of Property: ~'~.~,~ ~J- t~._ (~ c~9.~,_ ko-4~ ~
Owner Property Address: 7~O ~ ~"-td~-~) . '(~)
.
Tax Map No://~)O Section. "2"~.'- BI~ ~% Lot ~7~.~ (
Cross Street Vr'~ ~ (~[-3~ ~- L/t~(
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION ~0UI~S SVRWV ~Tq HEnJ~m~?EP~T~NT ~PRpVAr
Si~at~ofAppfic~t ~ ~(e I
Received by:
COUNTY DEPARTMENT Of HEALTH SER~qC~
PERMIT FOR APPEOYA L Of CONSTRUCTION FOR A ·
SINGLE FAI~iL% RESIDENCE OHLy
FOR M~I~UU OF~ ~ ~MS --
I
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