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Town Hall, 53095 Main Road
'`� P.O. Box 1179
®1 ��®��� Southold, New York 11971
JUDITH T.TERRY TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 345 R Residential X Non-Residential
Fee $ 10. 00 Septic Cesspool X
PERMIT ISSUED TO:
Name : ZULLI, MARIO R.
Address 1: P.O. BOX 234
City St Zip PECONIC NY 11958
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY HEALTH
DEPARTMENT.
Name Of Owner ZULLI , MARIO R.
Mailing Address 1 P.O. BOX 234
City St Zip PECONIC NY 11958
Property Address 1 ROUTE 48
City St Zip SOUTHOLD NY 11971
Tax Map No. section 69. 00 block 1 lot 4. 001
Cross Street MILL LANE
Building Permit Number Cross Reference:
Issue Date: 5/25/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
� � 41 :�. .
ti2)1
‘--)) 4. 95 ,c,"10 -
-1.._, ain Road
ti�•� P.O. Box 78
Southold, New York 11971
JUDITH T.TERRY TELEPHONE
TOWN CLERK
(516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
May 24, 1988
To: Victor Lessard, Southold Town Building Department
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy of application No. 349 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by Mario R. Zulli
Please review the application and location map and advise if the
project has received Suffolk County Health Department approval
and if we may issue the permit.
Please complete the form below and return it to my office.
Thank you.
eir •
d€44
Judith T. Terry
Southold Town Clerk
* * * * * * * *
I have reviewed the application and location map of the project
cited above and make the following recommendation:
APPROVE - 1
DISAPPROVE -
COMMENTS: c. 4 ov. aarad2aL
S.c . e •
\\C.73. 0.4.1
Signature
Date
OFFICE OF THE TOWN CLERK c\WFUL(/�
Town of Southold �'•,:' ": ,•,` � APPlication No.
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road o _,„,J _i r-r7 Construction
P. 0. Box 1179 ( f
O� Alteration
Southold, New York 11971
Telephone '741 ; NS° Residential
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ pj o
DATE A p-k , l7 ET
APPLICANT NAME: /4/) /00 R • Z. 0)-1- 1
APPLICANT ADDRESS: R0, ,o)( V I
PL CO t ) I)y / � •
SEPTIC CESSPOOL
•
• DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: MOO 2 / Z LLL- )
OWNER MAILING ADDRESS: go igc.? 23
P�fC oiicc i,/ 1 (crf'�
OWNER PROPERTY ADDRESS: goc)al- a S TI�OL�
TELEPHONE NUMBER OF CONTACT PERSON: 5`-" c6) — 2,
too 0 p
TAX MAP NO. : Section 6 ( Block / Lot
CROSS STREET: l,6 L6��
U"l
BUILDING PERMIT -NUMBER CROSS REFERENCE: -
Signature oA licant -
RECEIVED BY: 411/frpt,..4111_
'n CI rk's Office : .
DATE: *"U / �, '.
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