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ELIZABETH A. NEVILLE "0. Town Hall, 53095 Main Road
TOWN CLERK ; P.O. Box 1179
i' 4 Southold,New York 11971
REGISTRAR OF VITAL STATISTICS • '�
MARRIAGE OFFICER :NI.
� �i @*�1� Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER � V®I 14®,ii Telephone (631) 765-1800
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FREEDOM OF INFORMATION OFFICER - �,11,�
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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. 2336 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : ZOUMAS CONTRACTING CORP.
Address 1 : PO BOX 361
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 #R10-00-0125
Name Of Owner GAZZOLA, ROBERT E JEANNE
Mailing Address 1 27 MASITEE LANE
City St Zip EAST ISLIP NY 11730
Property Address 1 750 CEDAR DRIVE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 78.00 block 9 lot 5.001
Cross Street SUMMIT ROAD
Building Permit Number Cross Reference:
Issue Date: 6/07/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
I��ooi OFF04 CR3 32
til 0 ^ i' 7-V:
Town Hall, 53095 Main Road
ELIZABETH A.NEVILLE .'V: .
TOWN CLERK P.O. Box 1179
y • F Southold New York 11971
� � as � I � �
REGISTRAR OF VITAL STATISTICS 6127, �� Fax(631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER ,,..ss�,, 1° 'ii Telephone (631)765-1800
FREEDOM OF INFORMATION OFFICER ' `7. •t
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: June 2, 2000
Transmitted herewith is a copy of application No. 2424 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.
Linda J. Cooper
* * * * * * * * , *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments:
Signa
/S oI
Dated
' - ;,' '.J
//,/IIIIIi��_
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.AVULk .
OFFICE OF THE TOWN CLERK ��''
TOWN OF SOUTHOLD , � CQGy Application No j,/�
�
F117ABETH A.NEVILLE,TOWN CLERK
!1st Construction e-
P.O.BOX 1179 .�
SOUTHOLD,NEW YORK 11971 r"►+ Alteration
Telephone D,y %O ./ $10.00 - Residential
(516) 765-1801 = �1 ' ' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE 44/00
APPLICANT NAME: ZOUIE AS ilea ACTING conn.
APPLICANT ADDRESS: ;y M.Box 361
�IVadil�g River,NY 11792
SEPTIC �j CESSPOOL )D
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
0 N t rA-n.4 . Dw llt•&1.
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: i2ANIVe. 2 c 1.4- (124 Z2 oc II
OWNER MAILING ADDRESS: 5).7 �'I A�utS LAN
17r
OWNER PROPERTY ADDRESS:SSU e �2.
�-p t{1 = A 7 t3 u/kA '
®4d SOLS ,
TELEPHONE NUMBER OF CONTACT PERSON: sid- g --cf,C7.
8 (O
TAX MAP NO. : Section '7 Block Lot
CROSS STREET: (' M Mt -A-2
BUILDING PERMIT NUMBER CROSS REFERENCE:
/IP
Signature o4411.44t,ant
RECEIVED BY: /I
//// Town Clerk's Office
DATE: C.( /k ke).
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pale brown line 'to` ; ' _ lq(CAVA?ION'IN$PEC71 ONT ••'',"'..,"--4,:-,1:,:,'''
m e d i u m, :sand•'S:P ,'-''''FOR SANITARY SYS, 'ANT''' '.,:1,';',,,:,-,f, n°;:: ;: r'5,,,..,.-:-:.;',.:f:
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2.i3ffSEiS'(rift IMd ISJONS .(-- - . uvTEEs'iar�icateD'+ ve, ':JOB NO:' 00-119'`'< 'FILL,NO'.:''��': =:pAYSIDE'.TERRACE, -
HOWN' `HEREON FROM H�- SHILLL RLH'i'ONLY TCl THE FER50Aiq r.Tr • ..'! f!i 1; •
•TRUCTURES.TO THE PROPERTY FOR WHOM THE.SAIRMEY IS 'PRF' f ,''''' =-;!'' `r,"' S"
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SNES'ARE FOR A SFEORC FAIR PARED: AND ON'NG &NW TO, ": :,:' ', r _ ,�.'_ ''' ::r`, ,'"t,=7 ; ='!' �'
asE'AND USE AND THEREFORE '..• INE TRE cAMwWY'GONERNMB'1 LOT NUMBER '4°B:.S- t`'''
2E NOT MINDED TO GIDE THE ,,TAI-AGENCY AND LEADING iNSTh _ ''=• r ' '1
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OF FENCES, RETAINING. ,TUnON USTED HEREON,"AND.;TO %...,,.,,,•,,.,
''' ;;MAP'OF•BAYSIDE TERRAC ,..,,,,,.„,,,,,o • !r- ;... , •„_
/ALLS,'POOLS, PATIOS, PLANTING '-THE ASSIGNEES OF THE LENDING;` ' t ,,'1 ` ' r` 7..-'
+REAS, ADDITION TO BUILDINGS' ' INSTITUTION GUARANTEES API ',$' . S' ..' �'':4,-;,,,• ,
',RANYOTHERCONSTRUCTION. NOT' ANSFERABLE TO ADDmONALi:' �` ,�r=' n ,' ,r:; ,
INSTITUTIONS.:OR'SUBSEQUEN1t7.. SITUATE I,'' " ,
3NAUTHORIZED ALTERATION'OR' OWNERS:' ';:;;r; _ DAT,,' ,BAY�/I W ,;•. _ ;{ -:;`'
•DDITION TO THI$ SURVEY iS A .s.' , ':: ;; :' ,t`..: -..; '?",`,,,i",:,'".•.,', '<,
; pN n :C51; C 'OF Tias''SURVE i�Vp'T - _ :-TOWN OF, SOUTHOLD,'SUFFOLC;•.COUNTY.;N,Y.K',
:•tE 'NEW2,f+Oipl ATE EDUCATIa'1 BEARING THE'LAND SURVEYOR ' ; ,' '' ,`'- +••'I
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