HomeMy WebLinkAboutCordy ELIZABETH A. NEVILLE, MMC ��� y; .7 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 � °° n Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER ,, �� www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER �p .„ � '
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Sabrina Born, Southold Town Clerk's Office
DATED: March 22, 2018
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4591 for a Cesspool/Septic Tank Construction
Permit submitted by:
Ed Knoedler for Stephan han & ,Joan. Cordy,
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 a roval required from the SulTolk Cou�Realth Department
Signature
Dated
Town Hall, 53095 Main Road
ELIZABETHA.NEVILLE , ,w
P.O. Box 1179
TOWN CLERK Southold,New York 11971
REGISTRAR OF VITAL STATISTICS v �� Fax(631) 765-6145
MARRIAGE OFFICER
RECORDS AGEMENT OFFICER ,a Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ` southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION Y ALTERATION PERMIT
CESSPOOL P SEPTIC TANK
Residential 10 or Non-Residential ictio
Permit o.
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Brief Description^WW pn or Alteration
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Location of ProposedConstruction/Alteration:
Owner of Property:
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Name and phone number of contact person
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APPLICATION.NOTE: LOCATION MAP MUST BE SUBMITTED WITH
NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
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