HomeMy WebLinkAboutVasilapopoulos, Dhimetrio I~,LIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFOP~IATION OFFICER
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO:
FROM:
DATED:
RE:
Southold Town Building Department
Linda J. Cooper, Southold Town Clerk's Office
October 20, 2004
Cesspool Construction Application
Transmitted herewith is a copy of application No. 3386
Permit submitted by:
Best Modular Home~ Inc. for Dhimetrio Vasilapopouios
2 2 2004
for a Cesspool/Septic Tank Construction
Please review the application and location map and advise if this office may issue the permit.
Please complete the form below and remm it to me. Thank you.
I have reviewed the application and location map of the project cited above and make the following
recommendations: j
APPROVE
DISAPPROVE
Comments; ~~
Signature
Dated
TOW~ O~' SOUI'HOLD
~: :~x ~,BE'I'H A. N~EV]LLE, TOWN
P.O, ~X 1179
~0~, ~W YO~ 1197
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
Application No.3
Construction
Alteration
$10.00 .= Residential
$25.00 - Non-Residential
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No,
DATE '~/4~[
APPL,CA.T p/ t
^PPL,C^.T ADDRESS:
SEPTIC CESSPOOL~'~ ,.
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION /.
LOCATION, MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
· OWNER OF PROPERTY:
OWNER MAILING ADDRESS:. ?~' ~n~/~'Tt{ /..,.~ .:?,~J~) L.~'~ ,,~uiT' ~,~
OWNER PRopERTY ADDRESS:
4./Y
TELEPHONE NUMBER OF CONTACT PERSON: ~1
TAX MAP NO.: Section ~2s~x Block ~t~
CROSS STREET: ~'Oueo~ ~R.
'BUILDING PERMIT NUMBER CROSS REFERENCE:
RECEIVED.. BY: ~(~ ~
Town' Clerk's Office
Lot ~L~
:~..0 -o q - OIG7
.(-/ (41~glf~ of Applicant
SURVEY OF
L0~47
.4P
TERN,
F-AS ATSHORES
· GRE~fflPORT
tOWN OF SOUTHOI. O
SUFFOLK COUNT~, NEW YORK
S,C. T.M. DIST. I0~SEC. 033 BLK O4 LOT 26
0 20 40 60 80 100 120 140
SCALE: 1' = 40' 160
DATE:MAY1,1, 2004
~ET AREA: 17,1 ~ SQ. FT. = O.395 ACRE
VATION$ H ~E ON REFER TO APPROX MSL DA
AND ARE THE ~ ~SULT OF A TUM
CTUAL FIELD M,
NO SURFACE' TER EVIDENT WITHIN ~0'EASUREMENTS
TO:
2004-28O
I~4
UCENSE~
HANDS ON,
46 NORTH ROAD
TEST HOLE NO.2
PER FILE MAP
~LO&~AMLO
SAND
&
RAVEL -14.0'
m
iMPROVED
sERVICED BY pUBLIC wATER
94.9'
LOT48
IMPRoVED wATER
sERVICED BY pUBLIC