HomeMy WebLinkAboutCosmadelis, James ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATtOI~,
i ~ '/ ~¢f · m ~,i~FICE OF THE TOVg2q CLERK
TO: [~~~ng Department
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:
Linda J. Cooper, Southold Town Clerk's Office
DATED: November 1, 2005
Transmitted herewith is a copy of application No. 3537 for a Cesspool/Septic Tank Construction
Permit submitted by:
James Cosmadelis
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
recommendationsAPPROVE: ~
DISAPPROVE
Comments:
Signature
Dated
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRL~GE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
.~,Town Hall, 53095 Main Rc
P.O. Box 1179
Southold, New York 1197
· Fax (631) 765-6145
Telephone (631) 765-180(
southoldtown.northfork.n
oFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential ~ $10
Non-Residential ~ $25 __
Application No. 553
Permit No.
Applicant Mailing Address ~l ,~O~4Ot,O N~']
Septic Tank b~orCesspool
Brief Description of Proposed Construction or Alteration
Location of Proposed Construction/Alteration:
Owner of Property: '~ ~e~,l~.~,~ C~.~
Owner Mailing Address: ~ ~ ~'"[~[
Owner Property Address: I~,e~.~- ~.~ ~lq05
Name and phone number of contact person "~ ,1,4
Tax Map No:lO00 Section ~ Block O& Lot
Cross Street "T ~e.. l~ ~,,~Ltt t-t
=ROVAL
~SIDENCES
and on
tot
SURVEY OF PROPERTY
A T BA YVIEW'
TOWN OF, SOUTHOLD
SUFFOLK COUNTY, N Y.
1000 - 88 - 06 - 13.35
Scale: 1" = 40'
July 29, 2005
~JFFOLK COUN'I~ DEPARTMENT OF HEALTH SERVICES
05-POP
I em forelSer wlYe the STANDARDS FOR
AND CONSTRUCTION OF SUBSURFACE
DISPOSAL SYSTEMS FOR SINGLE FAMIL
end will a~lde by Ihe conditions sel forth It
permit to construct.
The Iocolions of wells ond cesspools
N shown hereon ore from /ie/d observot
nnd or frdm deto obfoined from other
· ~ or
'59 O0
I
coif~ ~oe ~eOeNc~ To MAP ,~'
ANY ALTERATION OR ADD/T/ON TO THIS SURVEY IS A VIOI. A TION ~
OF' SECTION 7~09 OF' THE NEW YORK STATE EDUCATION LAW.
EXCEPT AS PER ~E'CTION ?gO9 "SUBDt~ P. ALL CERTIFICATIONS
t~ON ASE VALID FOR T~II$'MAP AND COP1~$ 7'H~_R~O~' OI~.Y IF'
SAID MAP OR COPIES SEAR THE IMPR~$~E'D ~EAL OF' THE ~JRVEYOR
WHO~E ~ TURE APPEARS HEREON.
,4DD/TIONALL Y 1'0 COMPLY mTN SAID LAW TERM ' ALTERED BY ' ELEVATIONS ~tRE REFERENCED TO AN
MUST BE USED aY ANY AND ALI. SURVEYORS UTILIZIN¢~ A COPY ASSUMED DA TUM.
.~F ANOTHER SURVEYOR'S MAP. TE