HomeMy WebLinkAboutD'Antonio, Thomas M,a.I~i~IA(~E OFFIt~R
E~OOm~8 MANAG~ OFFICE
FI~EDOM OF INFORMATION O~FIC~I::
Town Hall, ~309§ Main Road
P.O. Box 1179
Southold, New York 11971
Fax (6~D 765-6145
Telephone (65D 765-180~
southolcltown.nor thfork.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
Application No. ~00°
l~ermit No- ~ ~
A~lic~t Name
Applicant Mailing Address
P. O. BOX.?87
LAUREL, NEW YORK 11948
S~tic T--rf' ___or Cesspool
Bri~fDesc2~tion of~.o(n'n~ctio..n_o.r Alttcrati~n .. , a
Location of Proposed Co~_~.tru~i~L~t~. cfi°n: .-rr_ _ /ff'~' ~[ '~)
T~ M~ No: S~fion ff~, .Block ~ ~t ~ ~ i
~ss
so~: ~oct~o~'~ ~s~ .~ s~~ ~ ~l~kc~i~co~~
Si~~~t - Dat~
Received by.
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
FOUNDATION 1ST
FOUNDATION 2ND
FRAMING / STRAPPING
FIREPLACE & CHIMNEY
] RRERESiST~TCO~STRUC110~ [
[ ] ROUGH PLBG.
[ ] INSULATION
[ ] FINAL
[ ] FIRE SA~ ~ ~' INSPECTION
] RRE RESISTANT I"BIETRATION
REMARKS:
~---/0 --/I INSPECTOR ~/~' '~~
DATE __