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ELIZABETH A. NEVILLE � j tA ‘ - Town Hall, 53095 Main Road
TOWN CLERK co, P.O. Box 1179
REGISTRAR OF VITAL STATISTICS � Southold,New York 11971
MARRIAGE OFFICER y Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER =__"®1 'too° Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ���
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2506 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 # R10-01-0028
Name Of Owner ENTENMANN, ROBERT
Mailing Address 1 PO BOX 361
City St Zip WADING RIVER NY 11792
Property Address 1 OLD FIELD COURT
City St Zip MATTITUCK NY 11952
Tax Map No. section 120.00 block 3 lot 8.026
Cross Street FARMVEU ROAD
Building Permit Number Cross Reference:
Issue Date: 2/06/01 Elizabeth A. Neville
Southold Town 'Clerk
(TOWN SEAL)
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ELIZABETH A:NEVI ;�E3 ' I t1, �®
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ELIZABETH Town Hall, 53095 Main Road
TOWN CLERK y P.O.Box 1179
TI ? 'r v� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS;.• , 1
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MARRIAGE OEFIGER = _ y � Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER =_�O,( jig .�,006 Fax
(631) 765-1800
FREEDOM OF INFORMATION OFFICER
_ ��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: January 31, 2001
Transmitted herewith is a copy of application No. 2594 for a Cesspool/Septic Tank Construction
Permit submitted by:
Zoumas Contracting for Robert Entenmann
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:
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Application No.
OFFICE N THE TOWN CLERK •O �
TOWN OF SOUTHOLD ?_.,.td,• .g' �;^ ', � � � Construction
ELIZABETH A.NEVILLE TOWN CLERKn A b t ,7.G •
P.O.BOX 1179 • o I: ,• ,, �f x', � , Alteration
SOUTHOLD,NEW YORK 11971 L Cn y :: c b;•, •�
‘.%). .‘' ,. n„,,'. , ,-�.• • $10.00 - Residential
Telephone - -�a/ ►� $25.00 -Non-Residential
(516) 765-1801 ..400
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
•
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TAN I< or CESSPOOL
Permit No.
Fee .$
DATE / !
APPLICANT NAME: zouivuts 6{)itlt—
CANT ADDRESS: ' ;;p,p °X361
APPLI dYadrn� ,
SEPTIC4_CESSPOOL
DESCRIPTION OF PROP SED CONSTR CT ION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTIO OR ALTERATION:
• OWNER OF PROPERTY : .0 Z.
• OWNER
MAILING ADDRESS: •,O go ' 3( 1 w A. N� , u'
OWNER PROPERTY ADDRESS: AO ` ( /0 C ovalV-c) J41
tS
TELEPHONE NUMBER OF CONTACT PERSON:
3
TAX MAP NO. . Section` �.0 _Block ----�`"Lot
CROSS STREET : j I '--/- `a 14 _`tin, ii O .1 ,
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signa-, Applicant
` -. RECEIVED BY:
::-1..,:-. ,:f , Town Clerk's Office • .
DATE:
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