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HomeMy WebLinkAboutPetikas, Nick ' ,O,�o&�/, S11FF0i�-co , y, G • ELIZABETH A. NEVILLE g, Town` Town Hall, 53095 Main Road TOWN CLERK , y Z t P.O. Box 1179 Southold, New York 11971 MARRIAGE OFFICER REGISTRAR OF VITAL STATISTICS `;Oy4 0��el',, Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER 1 * `1►sale Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER •oo 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. 3251 R Residential X Non-Residential Fee $ 100.00 Septic x cesspool PERMIT ISSUED TO: Name : PETIKAS, NICK Address 1: 48 MAPLE STREET City St Zip FARMINGDALE NY 11735 Descripton of Proposed Construction or Alteration NEW HOME FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT Name of Owner PETIKAS, NICK Mailing Address 1 67625 CR 48 City St Zip GREENPORT NY 11944 Property Address 1 SAME City St zip 0000 -;ax Map No. section 330.00 block 3 lot 16 cross Street GREENHILL LANE Building Permit Number Cross Reference: OCifY 176 Issue Date: 1/26/05 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) (3015 I •111 OFF04 OG: ELIZABETH A. NEVILLE �` ��` Town Hall, 53095 Main Road TOWN CLERK va Z P.O. Box 1179 • Ity REGISTRAR OF VITAL STATISTICS �O � Southold, New York 11971 MARRIAGE OFFICERy40. Fax (631) 765-6145 ifJ RECORDS MANAGEMENT OFFICER Ol * �a�.�� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER �,,.�'��� southoldtown.northfork.net 3 2004 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: November 4, 2004 Transmitted herewith is a copy of application No. 3393 for a Cesspool/Septic Tank Construction Permit submitted by: Nick Petikas 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 recommendations: APPROVE DISAPPROVE Comments: C; 2r ..�.+....Q Signature Dated ELIZABETH A.NEVILLE Town Hall, 53095 Main Road TOWN CLERK ' O P.O. Box 1179 REGISTRAR OF VITAL STATISTICS � �j, �� Southold, New York 11971 MARRIAGE OFFICER O � I/ Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER =_y �,e� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER0' * ,a01, 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 or Non-Residential @ $25 Application No. 3 3?3 Permit No. Applicant Name / L C- P6- Applicant Mailing Address ' / Fit /'f1-7JAIL( f (-7 31- Septic Tank V or Cesspool v lu ' 0 ,© Brief Description of Proposed Construction or Alteration I! C Location of Proposed Construction/Alteration: Pe7iq Owner of Property: flt C (C fr 1r K , C (d j Cr() Owner Mailing Address: Y El f'i)PCS • 2frk // 73C Owner Property Address: /1-) r C- k ,P€ clGgcCR . -11-eeiyotti Name and phone number of contact person &i L.K P / I K Tax Map No:/4500 Section t'e 3 3 Block vilt 3 Lot � Cross Street �1 �sN ,LL L?c e �}dc*'1" NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH HEALT DEPARTMENT APPROVAL /1 (3loy Signature of Applicant Date Received by: (./(/ SURVEY OF PROPERTY __ siTUATE g GREENPORT TONN1 N SUFF01-1( COUNTY, NY TM011dtiV.30 21:iVG VIIS.V,s•avaA a.a-aii SaUlt1X2 ' SURVEYED 06-10-2004 SWOOlciEE.,-WZ,C"7 TITAIII‘VViltod W-*---- E SUFFOLK COUNTY TAX # , ' COACAF.W I 1000-33-3-16 Ara0 3:31CialSZI,-.-Y1:1.,`Syiill'IS 'S' rf rwsz V VOA MOLLIIIILLS1010.10 t,tt';iidtlif MI -- / t-- . 9 C• . ---) •,.. 9,. -'.•L--) '''' --. ..;:.i c V o 9 ...) --... c.o ,..,, ,....„ .. -, -... ") c)--, --o t- 1:- \ " 0SW 0 0 - 05 i 1 11 I t."- 1 VI Isl •% illib to t- ,6 09 OW C% --- ------- % Ck a) . 4> . --- - k, P. • „.•.:: ,. 9 ' w '• 9r09 , 0 ,, , , s ‘1\0 --o . , 4.P \' , ,•, ---.1. -, -, C:k ', , • '„ cie • \ \\ Test Hole ,„0 6 t:3 ,,, \ v, t McDonald Seoscience , 0 ,, V„) -1 -6 0,..., '• ,s, 05-1cl-2004 o -, "5- EL=18. " --\ 9.„6-) , 2--9-, , Dark C'l I. % \ , 1• .-3.-•-. , 00 Mow, 6 1 09°,•-""'. 1 0 emmov. . ,3 0(!..'„•.. Palo rbis 0 0 \ ,, t 422f!:01'':> \\°: \A..--------.-. Gar. W'r. iwiel 17' No Water Encountered \ .6ce , ----1,000\•0 . Ac?) st,dc,Of* -OP° C154. e,\•\?' NOTES: c;OF NE:2 .r.e, ,.. 4Y-4,0- mcvet. ----•1-..z."-- I!'"! 0 PIPE FOUND I - '71=':•:`,T:'-%,":""" * , 'M ' • •7›,- '- SUFFOLK * ELEVATIONS REFERENCE COUNTY TOPO MAPS r 4. W AlI•••.,,At ' T.::=7::=2"e.t:: A '.:1! .-...p BUILDING ENVELOPE SETBACKS ACCORDING TO SECTION 100-244(NONCOMFORMING LOTS)TOWN OF SOUTHOLD ZONING LAN AREA = 101,526 sf or 0.45 acres JOHN C. EHLERS 1 D SURVEYOR = 30' 6 EAST MAIN STREET N.Y.S.LIC.NO.50202 GRAPHIC SCALE 1 66%111611MMIMIll. 1 RIVERHEAD,N.Y.11901 369-8288 Fax 369-8287 REF.\\Hp serveMPROS\04-189.pro • a r % p,