HomeMy WebLinkAboutElisseou, Evan (2) ,,,�o�osuFFoc,��oG,\
ELIZABETH A.NEVILLE ,� I y Town Hall,53095 Main Road
TOWN CLERK o - P.O. Box 1179
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REGISTRAR,OF VITAL STATISTICS ‘%6464,,,.
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MARRIAGE OFFICER
`F �� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER `=ySouthold, New York 11971
Mt ��i•1, Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER ,i' southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 3200 R Residential x Non-Residential
Fee $ 10.00 septic x Cesspool
PERMIT ISSUED TO:
Name : ROBERT C TAST
Address 1: YOUNG & YOUNG
City St Zip RIVERHEAD NY 11901
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR ONE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-04-0031
Name Of Owner ELISSEOU, EVAN
Mailing Address 1 730 HUDSON STREET, APT 4
City St Zip HOBOKEN NJ 7030
Property Address 1 1745 CENTRAL DRIVE
City St Zip MATTITUCK NY 11952
Tax Map No. section 106.00 block 2 lot 33.000
Cross Street ZENA ROAD
Building Permit Number Cross Reference:
Issue Date: 9/02/04 Elizabeth A. Neville
Southold Town clerk
(TOWN SEAL)
XIII
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ELIZABETH A.NEVII T E �'h'Z y
� � Town Hall, 53095 Main Road
TOWN CLERK O , P.O. Box 1179
REGISTRAR OF VITAL STATISTICS 'FIi Southold,New York 11971
MARRIAGE OFFICER `. Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER � �!��
_ Q �a Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER * ',,�� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
1, `L1�� TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: June 29, 2004 k
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 3341 for a Cesspool/Septic Tank Construction
Permit submitted by:
Young & Young for Evan Elisseou
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.
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments: - ..
/ ,
Signature
eid.".4....ej1-7 Avg)
Dated
�o��gUFFOU
ELIZABETH A. NEVILLE �`Z` O4 ; Town Hall, 53095 Main Road
TOWN CLERK p P.O. Box 1179
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Southold, New York 11971
REGISTRAR.OF VITAL STATISTICS Orrr
MARRIAGE OFFICER 1,� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER '` '* AF Telephone Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER = 4 * �991 southoldtown.northfork.net
��.....iii
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $10 x or Non-Residential @ $25 Application No. 3551/
Permit No.
Applicant Name Robert C. Tast
Applicant Mailing Address Young & Young 400 Ostrander Avenue
Riverhead, New York 11901
Septic Tank x or Cesspool x
Brief Description of Proposed Construction or Alteration New construction of sanitary
system for proposed two story house.
Location of Proposed Construction/Alteration:
Owner of Property: Evan Elisseou
Owner Mailing Address: 730 Hudson Street, Apt. 4
Hoboken, New Jersey 07030
1145
Owner Property Address: Central Drive
Mattituck, New York 11952
Name and phone number of contact person Robert C. Tast (631) 727-2303 -
Tax Map No: Section 106 Block 02 Lot 33
Cross Street Zena Road
NOTE: LOCATION MAP MUST E SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SUR WIT HEALTH DEPARTMENT APPROVAL
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May 17, 2004
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Si!,ature of Applicant Date
Received by: 6k
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Young & Young g
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400 Ostrander Avenue, Riverhead, .New`'York 11901 N 6,31-727-2303 1 1
(Vacant) (Dwelling With Public Water) Howard W. Young; Land sp neer �� C
\ Thomas C. Wolpert, Praf ii9,
\i, Robert C. Tast, Architect
Ronald E. Pfuhl, Landscape Architect x�
�� Douglas E. Adal/f�j. ;;P pypiVp!n E er %rt
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HEALTH DEPARTMENT USE
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�, 1 Z SURVEYOR'S CERTIFICATION
N. t1f �� 2733 g N • WE HEREBY CERTIFY TO EVAN ELISSEOU THAT THIS 0
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O 1t u, 2?,33 2/33 i �-4. PRACTICE FOR LAND SURVEYS ADOPTED BY T,<le'"`'` `,' "s
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0.0' 0 tri100' LOT 128 CAPTAIN KIDD ESTATES" E h
BROWN + 87. �'•26'000E
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c5�) - - dot Map Suffolk County, New York gXi
- - Supa;vis�OA �sta�es County Tax Map District 1000 Section 106 Block 02 Lot 33 SWI
16.0 of 130 ,1 „Capt0' �Pub\1c Watery >nas
BUILDING PERMIT SURVEY s
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FINE SAND SObalv�s\On EskoteS NOTE
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24.0' "Copt°1n K Pub11c tern 11 AREA = 11,866 SQ. FT. APR. 19, 2004 1 >p
With FEB. 3, 2004 ��� '
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• SUBDIVISION MAP "CAPTAIN KIDD ESTATES" FILED IN THE MAP PREPARED JUNE 9, 2003 4.•
OFFICE OF THE CLERK OF SUFFOLK COUNTY ON JAN. 19, 1949 , mit is
AS FILE NO. 167-`,2. SCALE 1" = 30' BP
= MONUMENT SET = MONUMENT FOUND 0- STAKE SET A= STAKE FOUND RO = ROOF •OVER • VERTICAL DAtUM = N.G.V. DATUM (M.S.L. 1929) JOB NO. 2003-0064 V 3
DWG. 2003_0064_bp J :
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