HomeMy WebLinkAboutCelano ELIZABETH A.NEVILLE,MMC ®�, Town Hall,53095 Main Road
i TOWN CLERK P.O.Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS Fax(631)765-6145
i MARRIAGE OFFICER ®� Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER ®� �,� www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER
OFFICE 0�oFI SOUO o CLE
RN
®
SEP 2 1 2017
TO: Southold Town Building Department
FROM: Sabrina Born, Southold Town Clerk's Office BUILDING DEPT.TOWN OF SOUTHOLD
i
DATED: September 21, 2017
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4521 for a Cesspool/Septic Tank Construction
Permit submitted by:
JNS Contracting for Fino Celano
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
.4v
Signature
Dated
ELIZABETH A. NEVILLE, MMC Fkt rar, Town Hall,53095 Main Road
TOWN CLERK P.O.Box 1179
® Southold,New York 11971
CA
REGISTRAR OF VITAL STATISTICS 10Fax(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: September 21, 2017
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4521 for a Cesspool/Septic Tank Construction
Permit submitted by:
JNS Contracting for Fino Celano
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 fiom the Suffolk County Health Department
Signature
Dated
ELIZABETH A. NEVILLE Town I-lall, 53095 Main Road
P.O. Box 1179
TOWN CLERK Cz
Southold, New York 11971.
REGISTRAR OF VITAL STATISTICS Fax (631) 765-6145
MARRIAGE OFFICER Telephone (631) 765-1800
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER > rf1southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTIiOLD
RECEIVED
SOUTHOLD WASTEWATER DISTRICT )-0
APPLICATION Sp +A 2017
CONSTRUCTION or ALTERATION PERMIT Southold Town Clerk
CESSPOOL or SEPTIC TANK
Residential Ca) $10 ✓ or Non-Residential, Oa $25 Application No. $,)_,\
Permit No.IRI()- 1 -00?
Applicant Name
cv-
Applicant Mailing Address 2S'L V-,c)Lri-6-
g1 Wq -2
�_'k )I-fq
Septic Tank—-----or Cesspool___,.,
Brief Description of Proposed Construction or Alteratl'on_-�C.�
................
Location of Proposed Coristruction/Alteration:
Owner of Property:
Owner Mailing Address:---3
Owner Property Address:1331 ......
Name and phone number of contact person
Tax Map No: Section Elock Lot
Cross Street 49P,0pvv1 L-Aaje-
.......
NOTE: LOCATION MAP MUST BE SU MITTED WITII APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY W I I H 11EAI.,TH DEPARTMENT APPROVAL
................
Signature ol'Applicant Date
Deceived by:
SAWTARY SYSTEM
PROV0E NEW c-*,ANITARY SYSTEM
FOR A NAXINUs , CIF W BEDROOMS
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