HomeMy WebLinkAboutPapadopoulos, Yiannis & Jacqueline ~gUFFO(,r~0
ELI7•ABETH A. NEVILLE, MMC ~y~ Gy Town Hall, 53095 Main Road
TOWN CLERK p ~ P.O. Box 1179
W ~ Southold, New York 11971
REGISTRAR OF VITAL STATISTICS p .tt Fax (631) 765-6145
MARRIAGE OFFICER 'y fit' Telephone (631) 765-1800
RECORDS MANAGEMENT OFFICER '1a wwwsoutholdtownny.gov
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF 30UTHOLD ~ ~ icer- r rr~
i~ u U L~
TO: Southold Town Building Department D
SEP 1 0 2013
FROM: Carol Hydell, Southold Town Clerk's Office
BiDG DEPT.
DATED: September 10, 2013 rowH aF souTrclo
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4156 for aCesspool/Septic Tank Construction
Permit submitted by:
Yiannis & Jacqueline Paoadoooulos
Please review the application and location map and advise if this office may issue the permit.
Please complete the form below and return it to me. Thank you.
* * * * * t r s * * r
I have reviewed the application and location map of the project cited above and make the following
recommendations: /
APPROVE
DISAPPROVE
Comments: Final approval required from the Suffolk County Health Department
Signature
1~ /G
Dated
. o~gUFFA(kcOG
ELIZABETH A. NEVILLE Town Hall, 53096 Main Roa~
" TOWN CLERK ~ ~ t P.O. Box 1179
REGISTRAR OF VITAL STATISTICS y. Southold, New York 11971
MAILRIAGE OFFICER ~ Fax (831? 766-8146
RECORDS MANAGEMENT OFFICER y~o~ Telephone (891) 786-1800
FREEDOM OF INFORMATION OFFICER ~ southoldtown,northfork.net
OFFICE OF THE TOWN CLERK
TOWS OF a0U
R
MLED,T TOWN OF SOUTHOLD
gVILD~~c~
NpA~99~0UTHOLD WASTEWATER DISTRICT '
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK r
Residential @ $ I O~or Non-Residential @ $25 _ Application No.
Pe 't No. /l
Applicant Name ~J 1/~ Q V
ApplicanS Mailing Address /
Septic Tank or Cesspool D /
- Brief Descrip ion of Proposed Construction or Alteration
Location of Proposed Constru ion/Alteratiorx:
Owner of Properly: !j
Owner Mailing Address:
v`
Owner Property Address:
Name and phone number of contact person 1 Ulm _ 'f:Jt p
Tax Map No: ~n 3 , Blocl___ Lot
Croas Street lLY!
NOTE: LOCATION MAP MUST BE SUBMTCCED WITH APPLICATION. NEVF'
CONSTRUCTION REQUIRES SUR H HE DEPARTMENT AP VAL'
~ 3
S of Applic t ate
Received by:
DE
SURVEY OF CERTIFIED T0.' JACOUELINEPAPADOPOULOS
YIANNIS PAPADOPOULOS
CR/BED PROPERTY
SITUA TE A T JOB NO.: 2013-135
~~E~N~~RT MAP NO.:
S U HOLD FILED: 1AND S
SUFFOLK COUNTY, NEW YORK REVISIONS: ~0 b
20 10 0 20 40 60 80 100 120 140 160 180 k Q ° y 9
SCALE: 1"= 40' DATE: APRIL 2 2013 ~
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERYICE>Z y iS~~.,p~ti~~~Q~
PERMIT FOR APPROVAL OF CONSTi2UCTION FOR A -~F~F NEW
SINGLL• FAMILY RESIDENCE ONLY
MAY 2 3 2013
DATE H. EF. 0. ~U- - (/~r ~ LICENSENO.:050363
APPROVED I.
FDR MAXI M of eEDRODM4 HANDS ON SURVEYING
E?(PIRES THR YEARS FROM DATE OF APPROVAL 26 SILVER BROOK DRIVE
FLANDERS, NEW YORK "
11901
TEL: (631)-369-8312 -FAX: (631)-369-8313
MAR IN .HAND .
S. C. D.H. S. ENDORSEMENTS ~ COPIES OFTH/S SURVEYMAP, EITHER PAPER OR ELECTRONIC, NOT BEARING
THE LAND SURVEYORS INKED SEAL OR EMBOSSED SEAL SHALL N07 BE
CONSIDERED TO BE A VALID COPY AND SHALL NOT BE USED FOR ANY PURPOSE.
LOT AREA: 17,027 SOFT = 0.391 ACRE
ELEVATIONS HEREON REFER TO APPROX NAVD 1988
PROPERTY LIES ENTIRELY WITHIN FLOOD ZONE X PROPOSED SANITARY CROSS SECTION
AS DEPICTED ON THE FE.M.A.
FLOOD INSURANCE RATE MAP
MAP NO.: 3610300176 H -EFFECTIVE DATE: SEPTEMBER 25, Loco usnROncovERrocanDE
P OE
PW.EL.: ISO
9 1/<>FT PITGIMIN ,g,Pr. MIN E•MMAX
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ALL ADJOINING PROPERTIES SERVICED BY PUBLIC WATER IN¢;u.e I . INV:I .e a olax DEEP TEPP DEPM •
UNLESS OTHERWISE NOTED. TM,N
NO WELLS VISIBLE WITHIN 150' OF SUBJECT PROPERTY. ~,a
GRJUM)WA,ER
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