HomeMy WebLinkAboutBATM Capital Corp ELIZABETH A. NEVILLE, MMC Town Hall,53095 Main Road
TOWN CLERK P.O.Box 1179
® Southold,New York 11971
CA
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: April 5, 2017
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4473 for a Cesspool/Septic Tank Construction
Permit submitted by:
Paul Davey for BATM Capital Corp.
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: Final approval required from the Suffolk County Health Department
Signature
Dated
ELIZAI3ETI1 A. NEVILLE r`Z` �� Town Hall,53095 Main Roa,
TOWN CLERK p P.O. Box 1179
Zc Southold, New York 11971
REGISTRAR OF VITAL STATISTICS by
MARRIAGE OFFICER O Fax (631) 765-6146
RECORDS MANAGEMENT OFFICER ���� �Q� Telephone (631) 765-1800
FREE,DOM OF INF OR.VIA'T ION OFFICER 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.?1® -1-0 b)
Applicant Name 14
Applicant Mailing Address t �-, V3. t�e'„�t (,,..V4 0
Septic Tank. or Cesspool
Brief Description of Proposed Construction or Alteration - ow, S E"vt,
Location of Proposed Construction/Alteration:
Owner of Property: i ltdr r ii ,
Owner Mailing Address: 1. I l i A, d.-@ 4
j
. 6 j
Owner Property Address: 13 R5 5 �^+k
Name and phone number of contact person Po,- L- Ov
Tax Map No: Section ,Block Lot
Cross Street
NOTE. LOCATION MAP MUST BESBAHTTED WITH APPLICA'T'ION. NEW
CONSTRUCTION RECDCJIIZES SURLYIi I EAIITI3 I) PARTMENT APPROVAL
sature`o`f"Applioarit... Date
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