HomeMy WebLinkAboutZoumas (2) OFFiCI[ OF 'I~ TOV~
TOWN OF SOUTEOLD
]7~ ETH A. NEViiJ.~ TOWN CLEP~
P.O. BOX 1179
SOUT~IOI. d), NEW YORK 119'/1
Telephone
(516) 765-1801
TOWN OF SOUTHO_LD
Application No.~~7.
Construction ~-~
Alteration "
$10.00 -Residential ,~
$25.00 - N0n-Residential ~'
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE
APPLICANT NAME:
APPLICANT ADDRESS:
SEPTIC~x~' CESSPOOL~
DESCRi T iON OP RO' OSED CONSTRUCTION
OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: ~0[JI~d~CONTRACT{N~J C'
P.O. 13oX 38{
. Wadin9 River. ~ 11792
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO.: S,ction ~ Block
BUILDING PERMIT NUMBER CROSS REFERENCE:
Office
~LOT AREA=36,110 sq, ft.
F. FL. ELEV,=
GAR. ELEV.=
C~4
LANE
GUARANTEED ONLY TO
',~ ~ C~.?~!-;:,~.i.~NI' O? ~'~ZY.L';H ~VJ¢~S
~HIT FOR APPROVAL OF C~.,T ~C~ .ON rO~ A
EXPIRES THREE YEARS FRO:,i DATE OF AP;~. ~ ROVAL
........... N ¥ LIC. NO, 048992
JOB NO.
00-354 FILE NO. ANGEL ~HORES
SURVEYED FOR
LOT NUMBER 20
MAP OF ANGEL SHORES
SITUATED AT BAYVIEW
TOWN OF SOUTHOLD, SUFFOLK COUNTY,
SCALE 1" = 50' DATE 10-l~-2000
FILED MAP NO. 9729 DATE 8-2~3-1995
TAX MAP NO. 1000-88-6-i3.22 (REF. IONLY) DISK
HAROLD F. TRANCHON JR. P.C~.
LAND SURVEYOR I
1866 WADING RIVER-MANOR RD. WADING RIVER,
NEW YORK, 11792
516-929-4695