HomeMy WebLinkAboutBernard ELIZABETH A. NEVILLE
TOWN CLERK : '
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION 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
FROM:
DATED:
Transmitted herewith is a copy of application No.
Permit submitted by:
Zoumas Contracting Corp
I',lU'~ - ~ ~ OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Southold Toxvn Building Department
Linda J. Cooper, Southold Town Clerk's Office
November 5, 2004
3394 for a Cesspool/Septic Tank Construction
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 remm it to me.
Linda J. Cooper
I have reviexved the application and location map of the project cited above and make the following
recommendations: ~.~
APPROVE
DISAPPROVE
Comments:
Signature
Dated
ELIZABETI-I A. NEWTr J.E
TOWN CLERK
REGISTRAR OF VITAL ~TATISTICS
MA.RRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFOP2W. ATION OFFICER
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York t 1971
' Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential ~ $10/h~ or Non-Residential ~ $25__
Application No. 55qq
Permit No.
Applicant Name
Applicant Mailing Address
ZOU~L~ CONTRACT~IG CORP.
PO Box361
~JU~ ~lu~u* ~
Septic Tank. ~ or Cesspool >~
Brief Description of Proposed Construction or Alteration
Location of Proposed Construction/Alteration:
OwnerofProperty: ~:~Ce~'~a.~: C#aZt/.-~
Owner Mailing Address: '~t~ ~A .~L&
Owner Prope~t~ Address:
,tit ~ou-r~ o~p.
Block ~ Lot /%
Name and phone number of contact person
Tax Map No: Section "']
Cross Street ~)~,ILL~W~ /~U~J td ~,.
NOTE: LOCATION MAP MUST BE SUBMITTED Wfl2TH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WJ~fH HEALT~IJ~EPARTMENT APPRgVAL
~igna~e~Applicant~ ~' bate
Received by:~
'Lr~T ATEA ~ 14,:~§S SQ. FT,
NOW OR FORMERE¥ 6ASEN EST.
/
./ DWELLIN~ - Pt,'BLI,.7.
~/~ N 8~37'10"E 80.00' -
58.8'
-~ ~/~J/ ~ PROP.
o cb DWELLING
/ 8
TH
/
~5~.o)
.o
TEST HOLE
Z
278.69'
FD
I~ON
NOTE: LOCATION OF WATE]~ MAINS
AND N)dOINERS WATER SUPPLY BY
OTHERS AND ~E NOT OU~NTEED.
DWELLING
S 82'37'10'~ 114.09'
IdON
ex;sting water main '~'
CUSTER
WATER / ~ ...........
.
: , , "3',~/DPROVAL
CERTIFIED ONLY TO:
ZOUMAS CONTRACTING CORP.
SUNRISE ABSTRACT
N.Y, LIC. No. 04B992
HAROLD F. TRANCHON JR. PENN. LIC. No. 2115-E
JOB No. 04--33,5
SURVEYED FOR
FILE No. 838 F
SITUATED AT SOUTHOLD
TOWN OF SOUTI-IOLD, SUFFOLK COUN3Y, N.Y.
SCALE 1' = 30' DATE 8-12-2004-
FILED MAP No. DATE
TAX IVaN= No. (REF ONLY)1000--70--9--13 DISK 2004-
HAROLD F. TRANCHON JR. P.C.
LAND SURVEYOR
P.O. BOX 618
1866 WADING RIVER,-MANOR RD. WADING RIVER,
NEW YORK, 11792
831-929-~695