HomeMy WebLinkAboutWickham L 419,
ELIZABETH A. NEVILLE,MMC Town Hall,53095 Main Road
TOWN CLERK a P.O. Box 1179
CA Southold,New York 11971
REGISTRAR OF VITAL STATISTICS Fax(631)765-6145
MARRIAGE OFFICER Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Sabrina Born, Southold Town Clerk's Office
DATED: January 3, 2017
RE: Cesspool Construction/Alteration Application
Transmitted herewith is a copy of application No. 4454 for a Cesspool/Septic Tank Construction
Permit submitted by:
Peconic Cesspool for Wickham
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:
APPROVE
DISAPPROVE
Comments:
Signature
Dated
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* * * RECEIPT * * *
Date: 01/03/17 Receipt#: 215213
Quantity Transactions Reference Subtotal
1 Septic Permit- Construct- Resid. 4454 $10.00
Total Paid: $10.00
Notes:
Payment Type Amount Paid By
CASH $10.00 Peconic, Cesspool
Southold Town Clerk's Office
53095 Main Road, PO Box 1179
Southold, NY 11971
Name: Peconic, Cesspool
P O Box 487
Laurel, NY 11948
Clerk ID: BONNIED Internal ID:4454