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Home My WebLink AboutMonsell, DavidELIZABETH A. NEW~ J,E~ MMC TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS OF MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall~ 53095 Main Road P.O. Box 1179 Southold, NewYork 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 August 16, 2011 Cesspool Construction Application AUG 1 6 BLDG. DEPT. TOWN OF SOUTHOLD Transmitted herewith is a copy of epplieation No. 4036 Percait submitted by: Peconic Cesspool for David Monsell 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 lo. gmion map of the project cited above and make the following recommendations: ~ APPROVE ~ DISAPPROVE Comments: Final approval required from the Suffolk County Health Department ELIZABETH A. NEV~.I,E 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 ~~C ~ ~'~_~ ~>~ Applicant Mailing Address ~ ~ ¢~-~ ~ ~/~Y Septic Tank or Cesspool F~ Brief DescripJion of Proposqt~onstmction 9r Alte~t~on. /. Location of Proposed Constmc~tio_n/Alteration.;. ~ f~ Owner of Property: f t~) ~/.~.~ ~)~/{ ~9~ Owner Mailing Address: Owner Property Address: ~.~.c~_'~ ~f~l/~A~ ~ Nme ~d phone nmber of cont~t person ~ ~ ~ /~ ~7~ Cross S~eet ~~ NOTE: LOCATION ~ MUST BE S~TTED ~T~ ~PLIC~ION. ~W CONSTRUCTION ~Q~S SURLY ~ ~OV~ Si~a~lic~t Date Received by: