HomeMy WebLinkAboutZazecki, Avis J FOLt
ELIZABETH A.NEVILLE $h `9* Town Hal], 53095 Main Road
TOWN CLERK P.O. Box 1179
2 Southold, New York 11971
REGISTRAR OF VITAL STATISTICS O Fax (516) 765-1823
MARRIAGE OFFICER �� y �� Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER ' *0/ 4) ..•
FREEDOM OF INFORMATION OFFICER
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1814 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : DIAMOND BUILDERS
Address 1 : P. O. BOX 2100
City St Zip GREENPORT NY 11944
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-98-0014
Name Of Owner ZAZECKI, AVIS AND JOHN
Mailing Address 1 C/O DIAMOND BUILDERS
P. O. BOX 2100
City St Zip GREENPORT NY 11944
Property Address 1 MAIN ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 70.00 block 7 lot 13.000
Cross Street CORWIN LANE
Building Permit Number Cross Reference:
Issue Date: 2/23/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
virt.
��,�i of FoLi-co
„.„............„
Ar/y
ELIZABETH A.NEVILLE •,``1� Gy Town Hall, 53095 Main Road
TOWN CLERK i p 1 P.O. Box 1179
•
y Z • Southold, New York 11971
REGISTRAR OF VITAL STATISTICS v' Fax Fax (516) 765-1823
MARRIAGE OFFICER ': y� 0`�0 Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER %..-VI �� ��1
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK ! 0 - Q d
TOWN OF SOUTHOLD
TO: Southold Town Building Department BLDG. DEPT.
•WN •F *UT 0 •
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: February 13,1998
Transmitted herewith is a copy of application No. 1888 for a Cesspool/
Septic Tank Construction Permit submitted by:
Diamond Builders for Avis & John Zazecki .
Please review the application and location map and advise if the project
has received Suffolk County Health Department approval and if this office
may issue the permit.
Please complete the form below and return it to me.
Thank you.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE
Comments:
ignat
Dated
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dwti Il,ll, 53095 Matti nom) ` i91� `� �I . Cutistt•lttllott
Southold,U. Box 11/9 ,o.• qb ' -r Alteration
lii ild, New York 1 19.1 l -r"o Nia.»• C;v- tl!
1 eleliliolu• ._1•e7i i :(4 ,��ttI Residetntlei_
(5161 765 • NMI ' '�"'''t Nuts-Itesidelt1171
I drill t)I' sot11110t_I)
S()U'11101.1) WAS 11;tVA I t:lt oust'OsAL DISTRICT
nl'I'I.IcA 11011
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I'et-tiilt No.
Pee $----------
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APPLICANT NAMt: f ict k o N D �u e—k 5
AI 'LICANT AnbtttSS: 443 Al►(rtt "( t', I'. 0. SOX :Z)00
rJ►reeltru'(f, II. V. 119.14 - ---_—
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DESCRIPTION Ur I'ttol'ost;h Ct)1ISI nut: tloll on ALERA-r ION
held (tale .tA.tt1)
LUcnt1UN MAP: Must be 7ttnclip(t Beret( before permit lacy 1e Issued, •
LocAr$o1.1 or rltot'ostb COIiSrtttc:i ION OR ALIALltntION:
o1VNtrt or- rltot'tttl'Y : v Is Sa N^% 'Z.4z. GcK 1
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Ghreifpolfi N.Y. 11944
OWNER $'lwt'1ItTY. /11)1)It1:SS : o HA b_
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tAx MAP Nu: : Sec1101t�._ /G. _ .. 111►irIc 7 Lot /.3 _ .
CROSS STREET
BUILDING 1'tttA41T Nt1Ailll:it (;Russ Itt:t r:lti llct_:. _
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,.-- SUFFOLK CO. HEALTH DEPT. APPROVAL .,
H.S. NO.
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_ - — 5 • - Stall FAIMLY DWELLtiG OILY
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--:..);.::,,::. -:i.:: .. r....,--!;-.-... '''''' ' e !XiiRES TREE YEARS FRC* DATE OF APPROVAL
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STATEMENT Of INTENT
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..,........ MAIN =AC ' NYS. IZTE 2`..:: • 8 \••./grEf:' frif-..IIN: .All-
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THE WATER SUPPLY AND SEWAGE DISPOSAL
.,•-tc• SYSTEMS FOR THIS RESIDENCE - WILL
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so L4Aesch.,.._1..,s,N•59•0440*E-
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CONFORM TO THE STANDARDS OF THE
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n.., / it 1 SUFFOLK CO. DEPT. OF HEALTH SERVICES.
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- - FOLK COUNTY DEPT. OF -I ALTH
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„ . SUFFOLK CO. TAX MAP DESIGNATION.:
DIST. SECT. BLOCK PCL.
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. ' OWNERS ADDRESS:
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TELEDYNE POST NID32,
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