HomeMy WebLinkAboutZoumas (2) ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRP~ OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
JAN 2 0"
OFFICE OF THE TOWN CLERK
TOWN OFSOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
TO:
FROM:
Southold Town Building Department
Linda J. Cooper, Southold Toxvn Clerk's Office
DATED: January 20, 2005
Transmitted herewith is a copy of application No. 3424 for a Cesspool/Septic Tank Construction
Permit submitted by:
Zoum~
Please review the application and location map and advise ii the project has received Suffolk County
Health Department approval and i£ this o£fice may issue the permit.
Please complete the form below and return it to me.
Linda J. Cooper
I have reviewed the application and~tion map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE , -"'
Signature __
Dated
ELIZABETH A. NEV~.T.E
TOWN CLERK
REGISTRAR OF MITAL STATISTICS
I~GE OFFICER
RECORDS M~NAOEMENT OFFICER
FREEDOM OF INFOP~ATION OFFICER
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 91971
· Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.north£ork.net
OFFICE OF TI-IE TOWN CLERK
TOWN OF $OUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
-CESSPOOL or SEPTIC TANK
Residential ~ $10 ~ or Non-Residentiai ~ $25
Application No.
Permit No.
"Applicant Name ~
Applicant Mailing Address
ZOUIL,~ CONTRACTING CORP.
PO BOX361
tl~ * ~}luaa. MV 44'/'~
Owner Prope~") Address:
Name and phone number of contact person
Tax Map No: Section t~
Block 0 t,/ Lot 17./?'
Cross Street Atxr6/~/t~ ~-!~'~' · ·
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY ~y~ITH HEA~j~PARTMENT APPROVAL
Received b .~~. ~ Si~re of Ap~
I
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