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ELIZABETH A.NEVILLE Gym* Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
ti' Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS rr't'�� Fax(516) 765-1823
MARRIAGE OFFICER 4 1
RECORDS MANAGEMENT OFFICER �l �a �� Telephone (516) 765-1800
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. 1866 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : ZOUMAS CONTRACTING CORP.
Address 1 : 18 DEERFIELD DRIVE
City St Zip WADING RIVER NY 11792
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 #R10-98-0033
Name Of Owner ZOUMAS CONTRACTING CORP.
Mailing Address 1 18 DEERFIELD DRIVE
City St Zip WADING RIVER NY 11792
Property Address 1 DUCK POND ROAD
City St Zip CUTHCOGUE NY 11935
Tax Map No. section 83.00 block 4 lot 15.000
Cross Street THAR LANE
Building Permit Number Cross Reference:
Issue Date: 5/18/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
00/II 760. 0
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ELIZABETH A.NEVILLE ��`` Z� Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
y Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS G:4 Fax (516) 765-1823
MARRIAGE OFFICER :
RECORDS MANAGEMENT OFFICER y�pl �.a�;�0 Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER •
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: May 15, 1998
Transmitted herewith is a copy of application No. 1940 for a Cesspool/
Septic Tank Construction Permit submitted by:
Zoumas Contracting Corp
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:
Signature
Dated
•
OFFICE OF THE TOWN CLERK 'c.SFOte
Town of Southold �� CO ', Application No. /9 '71G'
Judith T. Terry, Town Clerk .�
Town Hall, 53095 Main Road a < $10.00 - Residential L/
P. O. Box 1179 tri �` $25.00 - Non-Residential
Southold, New York 11971 O �`�
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Telephone = 1 * . , '�
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
N � ( t^ �( C / oO'•
ialEBYSPERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE r// g ,p
ZOUMAS CONTRACTING CORP.
OWNER NAME: 18 Deerfield Drive
Wading River,NY 11792
OWNER MAILING ADDRESS:
OWNERZOUMAS CONTRACTING CORP.
PROPERTY ADDRESS:
18 Deerfield Drive — — ---
Wading River.NY 11792
OWNER TELEPHONE NUMBER: ‘i.z1q-c/S70
TAX MAP NO. : Section g 3 Block 41 Lot / C
CROSS STREET: CoLIJtA. o c T*(Z. / E AND (i),UL1=POMD PAQ
C N 094 C�
TYPE OF SYSTEM: Septic Tank New f Existing
Cesspool New ,/C Existing
Residential >4' Non-Residential
LOCATION MAP: Must be attached hereto before permit may be issued.
(Locate building and system; give north arrow and feet
of distance, approximately, to building and closest road.)
)Jjj3 UM01 Rloinnoj RECEIVED ignature L• . icant
8661 AVW MAY " 1998
RECEIVED BY:
03A1333 T O , =
DATE:
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• JOB NO. 97-269 FILE NO. WOODBINE MANOR
A OFFSETS (OR DIMENSIONS) GUARANTEES INDICATED HEr;;UN SURVEYED FOR
SHOWN HEREON FROM THE SHALL RUN ONLY TO THE PERSON
STRUCTURES TQ THE PROPERTY FOR WHOM THE SURVEY IS PRE. LOT NO. 15
STM ARE FOR'A SPECIFIC FUR- PARED, AND ON HIS BEHALF TO
—' W:-AND:USE AND THEREFORE THE TTTLE COMPANv, GOVERNMEN MAP OF WOODBINE MANOR
L401,,cor imam) TO GUIDE THE TAt AGENCY AND LENDING INE 1.
OF FENCES. RETAINING TUTION LISTED HEREON, AND TO
%x POOLS,. PATIOS.-FLAWING THE ASSIGNEES OF THE LENDING
At -ADDITION 1O BUILDINGS INSTITUTION. GUARANTEES ARE SITUATED AT CU TCHOGUE
conetc etruK urea NOT TRANSFERABLE TO ADDITIONAL /fit
INSTITUTIONS OR SUBSEQUENT 47pif81N OF SOU T HOLD — •'+ SUFFOLK COUNTY N.Y
.•. ALTERATION OR. OWNERS. `ter
>O TeMf OPI a A c . so. Rae 7...23 —199 7
,,f �.Sl�CYION 7201 OF COPIES OF THIS SURVEY MAP NOT St1�.1< 1
4,c,;- your STATE EDUCATION BEARING THE LANA •••S
INKED SEAL OR .M
FILED MAP NO. 8239 • DATE 12•- -1986
TSD ONLY`,TO co IRAN 4- TAX MAP NO. 1000'00,7,.4-15 .. (RSP ONLY) DISK 176
.O ti -ow, HAROLD F� 'SRA 14'.JR.P.C.
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!� �, 9ti �p• � 184'6 W DING RIVER'Mf1ANOR RD. WADING RIVER,
��N 1 Oto °• 0489 NEW 4000 1 1791
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