HomeMy WebLinkAboutZazeski JUDITH T. TERRYTown Hall, 53095 Main Road
a P.O. Box 1179
TOWN CLERK
REGISTRAR OF VITAL STATISTICS J Southold,-New York 11971
MARRIAGE OFFICER �® i� Fax (516) 765-1823
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s� ® �} Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 1968-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner ZAZESKI, DAVID AND JEAN
Mailing Address 1 P. O. BOX 259
Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
Property Address 1 145 CONLIN ROAD
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-4341
Tax Map No. section 139.00 block 3 lot 41 .000
Cross Street FREEMAN AVENUE
Date Of Last Pump Out 0/00/00
Issue Date: 9/10/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
•
OFFICE OF THE TOWN CLERK •S�FFOL4-
Town of Southold � Application No. ?6�
CQ
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road w 4 $10.00 - Residential ® • Ob
p. O. Box 1179 u' _: s: <' tri ; $25.00 - Non-Residential
Southold, New York 11971 O
Telephone "4Q( . Y►° ��'�
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ 1P)• 6?
DATE C `
OWNER NAME: IN'l5'A % 4"-- -.X E P3 Z47 S
OWNER MAILING ADDRESS: R45 e.,60e.9t.!_LLU DA
tbal,,
OWNER PROPERTY ADDRESS:
OWNER TELEPHONE NUMBER: CS I.CD. q 344
TAX MAP NO. : Section i",3 Block 3 Lot
CROSS STREET:
TYPE'OE -SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: IN3I,Ve,P.
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.)
411"j—, Signatur of ppl nt
BY-: -' Town erk's Office
. -R1�IVED. --- - . - -
DATE:
SEP 1. 019•
•
Town Clerk Southold
•
= •
C
_ i
VENAEf\
Acn SUFFOLK COUNTY HEALTH DEPARTMENT / • UNAUTHORIZED ALTERATION OR ADDRIOA
TO THIS SURVEY` , HATE DEC 12 1972 H. D. REF. D//Y/� SECTION 7209 OFSTHE VNEW YORK STATE
EIOLATION OF
EMAN N CZ,
REDUCATION LAW.
,F 1 COPIES OF THIS SURVEY MAP NOT BEARING
C11 The sewage disposal and water supply THE LAND SURVEYOR'S INKED SEAL OR
Oi ' ENROSSED SEAL SHALL NOT BE CONSIDERED
{-- faciliti es for this location have been TO BEA VALID TRUE COPY
ins inspected bythis dog ent found
Zbe y. VA, ONLY FES INDICATEDET5ON HEREON SHALL RUN
to satisfactory. ONLY TO THE PERSON FOR WHOM THE SURVEY
l IS PREPARED,AND ON HIS BEHALF TO THE
1 _ TITLE COMPANI,GOVERNMENTAL AGENCY AND
O Chief of
General Engineering• LENDING INSTITUTION LISTED HEREON,AND
TO THE ASSIGNEES OF THk LENDING INSTI-
Rto
Services TUTION GUARANTELS ARE NOT TRANSFERABLE\ .
TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT
I OWNERS.
Lot , �� J50'331el�
NOTE:
4)::. rrNONUMFNT
14�1E• m ,t c _ 40 5 'O SUED!V/S/ON NAP F/LED/N THE OFF/CF
Oo34 si - -•3A• N OF THF CLERK OF SUFFOLK COUNTY cc/0C
-70°34'40
` 1TIB t� ijO.G/ =� O_ 1 JUNE 24,/929 AS MAP NO.577.
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_ I /• Q_9 �B, z��' "/ \ Co REVISIONS YOUNG & YOUNG - -
N C:)., /sJo" / S,__ ��� G� NOV. I, 1972 400 OSTRANDER AVENUE, RIVE .. YORK
07.,7- / ZeTI •-
r i�p�' l 9-/ el , \ DEC.6, 1972 ALDEN W.YOUNG -• W.YOUNG
O F .1,:-- I / PROFESSIONAL.ENGINEER AND ELD WA i YOR
d,„.••''
• I 150 33 \ O I LAND SURVEYOR.N.Y.S LIC NO,12845 :P N To 0 45893
o �' SURVEY FOR: *I i'"'
P d DAVID ZAZESKI a JEAN ZAZE'� ''. ic
,ii. .
o ,q .401LOTS 8 a 9 "GARDEN HEI HI Sr.
\- e1:F 0034 7 N
S•1 4c O 4589'
0t 1 f' a
L AT GUA-S� f ��I'�"FO
MATT I TUCK
.----------\
SOUTHOLD SECUR ES GUARANTY CO.
TOWN OF SOUTHOLD SAVINGS BANK
1 SUFFOLK CO., N.Y. BY e , C
' SCALE. IN=40N DATE:JULY 28,1972 NO.,6(772 5�
DIFIZGLN 25 11846
41,
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