HomeMy WebLinkAboutZoumas OFFICE O? ~ TOWN CLEZ.K
TO V,'~ O,~ ~OUTHOLD
r ,?~ EE~. ^. NEVU ~,LLE, TOWN CLERK
Telephone
516) 765-1801
Application No.
Construction
Alteration
$10.00 -Residential
$25.00 - N6n-Residentiat__
TOWN OF SOUTHOLD
SOUTHOLD \VASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONST'RUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE
APPLICANT NAME:
APPLICANT ,~DDR~SS:
· .::.,.W?P.O:;J]6x 361
DESCRfPTION OF I~ROPOSED CONSTRUCTION OR ALTERATION
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:'
O~'tNER MAt~INC ADDRESS: ~.0 ~¢~ 3aZ ~
LOCATION MAP: Must be attached hereto before permit may be Issued.
O'¢/NER PROPERTY ADDRESS:~
TELEPHONE NUMBER OF CONTACT PERSON: 5 ~'~-q-'~70
TAx ~,~^p NO.: S~c~io~_z(~ ~,o~ / Let ,...¢~
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
RECEIVED BY:
OAT E:
UDT AREA,- 9.04.8 sq. ft.
F.F. ELEV.,,. 72..5
CAR. ELCV.= 70.5
OLO STONE
than 150'
r.oO'
ce#pool
NO7~: LDCA'~ON OF ADJOINERS WELLS AND SANITARY SYSTEUs BY OTHERS
AND ARE NOT GUARANTEED.
CERTIFIED ONLY TO:
ZOUMA~ CONTRACTING CORP.
SUNRISE k~STRACT CORP.
ROLO F. TRANCHON ,.IR. PENN. LIC, No. A115-E
TEST HOLE
BY 14cOONALD GF,.O:~IENCE
11-1 ~2002
2. brow~ .lib/ -,and
pal~ brown flr~
SW
JOB No. 02-458 FiLE No. 798F
SURVEYED FOR ZOUMAS CONTRACTING CORP.
OL
$iTUATEO AT SOUTHOLO
TOWN OF SOUTHOLD - SUFF'~LK COUNTY N.Y.
SCALE 1' *. ~0' DATE 10-22-2002
TAX MAP No. (REF ONLY) 1000-63-1-5 DI~K 500
HAROLD F. TRANCHON JR,
LAND sURVEYoR . ,~k%LS3.~. ?, '~'
P.O. aox
1866 WADING RIVER-4~ANOR'~I~:
NEW YORK, 1179~ .c '~.~
,