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Home My WebLink AboutCarcich fOL�cO ELIZABETH A.NEVILLE,MMC may® r/y Town Hall,53095 Main Road TOWN CLERK P.O.Box 1179 N Z 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 D [ECEME TOWN OF SOUTHOLDD TO: Southold Town Building Department JUL 19 2017 FROM: Sabrina Born, Southold Town Clerk's Office RUMDING DEPT. TOWN OF SOUTHOLD DATED: July 18, 2017 RE: Cesspool Construction/Alteration Application Transmitted herewith is a copy of application No. 4498 for a Cesspool/Septic Tank Construction Permit submitted by: Peconic Cesspool for Fred Carcich 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 4 Comments: � �4a RECEIVED Signature ur D JUL 3 1 2017 Dated Southold Town Clerk fF OL ELIZABETH Aa NEVILLE,MMC Town Hall,53095 Main Road TOWN CLERK P.O. Box 1179 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 FFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Sabrina Born, Southold Town Clerk's Office DATED: July 18, 2017 RE: Cesspool Construction/Alteration Application Transmitted herewith is a copy of application No. 4498 for a Cesspool/Septic Tank Construction Permit submitted by: Peconic Cesspool for Fred Carcich 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 Taman Hall,.53095 Main Road P.O.Bos 2279 ca Southold,New-York 22971 TOWN y�AL STA'TISZ�CS `�' ; �� 'as(632)?6v-6145 REGI OF OMCER ,_:: 'p �`dQPliane(632)7651800 E�=F.DSMAMA� OFFIC a .=t3aoldto•nortbfork.nSt MBM=OF tmRM&TION OPMER osmcg `F TOWN CLERK TOWN OF SOUTHOLD SG . O w ;;- WA R DISTMCT CONSTRUMON.Or ALTERATION PERMU LM�L- C=T ` .d $25 .A,ppfi OnNOResidential @ . $10LI or NonR.esd Q �,pp ,Caxlt � PLIC CESSPOOL P O. Bax .487 y—OM 119,48 LK UIPUL!, STfie Tom::;F Pr Oel Brief Dem,'-00n a sed ce c ion or, o , LoCago,U of proposed Construed owner of Addrm 0-,;mer Properbi e and phone n . Of=taot Tax MV O® Block Loth Cross APPLICO ® LO r CONSTRU t Date p,eceivedb d � ooG� r * * * RECEIPT * * * Date: 07/18/17 Receipt#: 225972 Quantity Transactions Reference Subtotal 1 Septic Permit- Construct- Resid. 4498 $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:4498