HomeMy WebLinkAboutScibelli, GabrielETJT. ABETtl z~.. NEVIT.I,F., RMC, CMC
TOWN CLERK
REGISTRAi~ ~)F VITAL STATISTICS
MAI~IAGE OFFICER
RECORDS ~AGEMENT OFFICER
FREEDOM OF ~E!N~FORMATION 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:
RE:
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Southold Town Building Department
Carol Hydell, Southold Town Clerk's Office
November 3, 2008
Cesspool Construction Application
Transmitted herewith is a copy of application No. 3836
Permit submitted by:
Donald Feller for Gabriel Seibelli
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.
I have reviewed the application and location map of the project cited above and make the following
recommendations:
/
DISAPPROVE
Comments:
Signature
Dated //~;~/~ ~//~ ff
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAOEMENT 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. ~ ~3 (o
Permit No.
Applicant Name ~
Applicant Mailing
Septic Tank)/' or Cesspool
Brief Description of Proposed Construction or Alteration
~cation of Proposed Constmctio~Altcration:
Owner of Prope.y:
Owner M~ling Ad.ess:
Owner Property Address: ~-~0 ~ P~)I~T ~/1~
Name and phone number of contact person
Tax Map No: Section o~C> Block
Cross Street ["~----'~--~ [~~~ d
Lot t ~
NOTE:
CONSTRUCTION REQUIRES S~AL~.~
Received by: ~ /~licant
LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
DEPARTMENT APPROVAL
Date
JAN 23 2009
BLDG. DEP[
1~9~ OF Sou*rHOLD
106
LANDING
SUFFOLk:( COUNTY DEPARTr4:'NT 07 HI~ALTH ~ERVIGEU
PERMIT FOR APPROVAL O~ CONSTRUCTION FOR A
EXPIRES THRE,~ YEAR~ FP, O['~, D.~G' ~ OF APPROVAL
Water L~ne(s) M_].]~,T Be Inspected By The
Call 852-5700,~ ~:l ' ~ ~ ~. ; ,dvance,
CERTIFIED T(
GABRIEL SC
PECONIC Al