HomeMy WebLinkAboutZaleski JUDITH T.TERRY kt G�'�; Town Hall, 53095 Main Road
TOWN CLERK a P.O.Box 1179
$
REGISTRAR OF VITAL STATISTICS O
ns
�` ���, Southold,New York 11971
Fax(516) 765-1823
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER 0.( 4.0.0 Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER •01
,o�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3521-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner ZALESKI, JOSEPH W.
Mailing Address 1 235 DEEP HOLE DRIVE
Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
Property Address 1 235 DEEP HOLE DRIVE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-8162
Tax Map No. section 115.00 block 13 lot 2.000
Cross Street NEW SUFFOLK AVENUE
Issue Date: 10/08/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK sci\Uu(�•''-
Town of Southold �� Application No3c�c
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road 8 ..' .r,
$10.00 - Residential
P. O. Box 1179
$25.00 - Non=Residential
Southold, New York 11971 :7_0
.Telephone 4 y1
(516) 765-1801,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
•
DATE 4/3/90
OWNER NAME: /
OWNER MAILI /DDR' S: 23 0052.72,223:9402-
OWNER PROPERTY ADDRESS:
OWNER TELEPHONE NUMBER: .$ �j
'l J/S--)3 —2-
TAX MAP NO. : ection /Ts' Block 3 Lot -,
a
CROSS STREET: '\-eA.4.) \,� O K
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential 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 bLilding and closest ,road.)
ignatu f Applicant
RECEIVED BY: —woof,� /'
Tow Clerk's Office - -
.a
DATE: RECEIVED -
OCT 41996
Southold Town Clerk
E e r'is s r o o J--es I
N --Fe--5 0 - -* -
vki ‘. Ncoo
i0
\ 1r
C
ice.
"t
, I 1
I,.
. .740 ci_s r
'4
0
v
czo
O
C
, 1 .00# -gp 74c)i-i: p is -_-. i
1 l