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HomeMy WebLinkAboutFHP Enterprises • I ELIZABETH A.NEVILLE,MMC 0./... ; , .0 Town Hall,53095 Main Road TOWN CLERK ; t0,-;* .Y , ' Nb ,4 P.O.Box 1179 �K , 't � ; Southold,New York 11971 REGISTRAR OF VITAL STATISTICS '' r i,,'f �I Fax(631)765-6145 MARRIAGE OFFICER ��t'`®:;,. ..-'iset.1Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER Di . .• �,0' www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER "- �'� 10 OFFICE OF THE Tie WN CLERK �- TOWN OF SO 6 THOLD 10 '- = _ . .7::_i. i TO: Southold Town Building Department .� u JA I\1 - 1 2016 r FROM: Carol Hydell, Southold Town Clerk's O Tice I DATED: January 4, 2016 RE: Cesspool Construction Application Transmitted herewith is a copy of application No. 4 '62 for a Cesspool/Septic Tank Construction Permit submitted by: FHP Enterprises . Please review the application and location map and a. ise if this office may issue the permit. Please complete the form below and return it to me. I hank you. * * * * * * * * * * * I have reviewed the application and location map of 1 e project cited above and make the following recommendations: APPROVE - DISAPPROVE Comments: Final approval required from the Suffolk County Health Department r /! r Signature 0//21j6 Dated eo ditl ELIZABETH A. NEVILLE p 11 Town Hall, 53095 Main Road TOWN CLERK �� p P.O. Box 1179 t x Southold, New York 11971 REGISTRAR OF VITAL STATISTICS ; ' MARRIAGE OFFICER . Fax Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER = �o ..07,et•1� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER = ' southoldtown.northfork.net OFFICE OF TH 0 TOWN CLERK TOWN OF SSUTHOLD SOUTHOLD WAST 0 WATER DISTRICT APPLI• • TION CONSTRUCTION or • TERATION PERMIT CESSPOOL or .EPTIC TANK Residential @ $10 /or Non-Residential @$25 Application No. LI'5 `, Permit No. Applicant Name RIP Pliifi=l-P '( • Applicant Mailing Address g 1 q / I G� Swaltia ll Septic Tank Cesspool Brief Description of Proposed Construction or A teration Li i 1' . ' Location of Proposed Construction/Alteration: Owner of Property: PW/ rAl, i r&S • Owner Mailing Address: Mg / Avfotd . 1197 Owner Property Address: (P c MIr/ Name and phone number of contact person /OA g0 E J& C11 �(�(� .'7'70• '7 Tax Map No: /DO° Section /0 ,��BlIlock 61f Lot VI Cross Street b� w jtJ '� /A NOTE: LOCATION MAP MUST BE S :MITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY TH HEALTH DEPARTMENT APPROVAL Signature of Applicant Date Received by: C.4( i. 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