HomeMy WebLinkAboutZappala, Agatina /Iii
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ELIZABETH A. NEVILLE �� yd` Town Hall, 53095 Main Road
TOWN CLERK 4 y Z ; P.O. Box 1179
REGISTRAR,OF VITAL STATISTICS �Oy� ��4�� Fax (631) 765 6145
',' Southold, New York 11971
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER t/ ' �* ,doTelephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ,/, ,./�� 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. 3277 R Residential x Non-Residential
Fee $ 100.00 Septic x Cesspool
PERMIT ISSUED TO:
Name : ZAPPALA, AGATINA
Address 1: 429 HERRICKS ROAD
city St Zip NEW HYDE PARK NY 11040
Descripton of Proposed Construction or Alteration
N/D
FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT
Name Of Owner ZAPPALA, AGATINA
mailing Address 1 429 HERRICKS ROAD
City St Zip NEW HYDE PARK NY 11040
Property Address 1 THE LONG WAY
city St Zip EAST MARION NY 11939
7ax Map No. section 300.00 block 2 lot 121
Cross Street
Building Permit Number cross Reference:
Issue Date: 2/01/06 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
— 3277
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ELIZABETH A. NEVILLE �� Town Hall, 53095 Main Road
TOWN CLERK ti� Z ; P.O. Box 1179
%10 PrI Southold, New York 11971
REGISTRAR,OF VITAL STATISTICS : 00�"V 0 Fax (631) 765 6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER `t►a,��� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER � ,,�is" southoldtown.northfork.net
JAN I 2 OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: January 12, 2005
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 3421 for a Cesspool/Septic Tank Construction
Permit submitted by:
Agatina Zappala
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
e/41/0.5--
Dated
f �
t ELIZABETH A.NEVILLE o`Z` 4 Town Hall, 53095 Main Road
TOWN CLERK O P.O. Box 1179
y` Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS W �
MARRIAGE OFFICER
O t �� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER %.4:# O��,I Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER . 4, ���'� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT •
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Application @$10 or Non-Residential @$25 No. L1-21
Permit No.
Applicant Name PGA.-(i,J P z A P c13)---
Applicant
A1-Applicant Mailing Address Li 2.4 4--i&-6) 1:C f ✓�9
Septic Tank or Cesspool
Brief Description of Proposed Construction or Alteration
Location of Proposed Construction/Alteration:
Owner of Property: 6.-P 2i)P P fl)- 0
Owner Mailing Address: L1`.A R ILK'5 8o
tif/fx- /lei
Owner Property Address: ,/)ST M R R i)A) 7kt LONG_ iA)-15/
- 7 (242- - 36, 1.3
Name and phone number of contact person
Tax Map No: Section 3 0 Block a,. Lot I
Cross Street
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
,(9ASa ,_ /-- 10-05
Signature of Applicant Date
Received by: .0,Ga`7p
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SURF OF LOT SUFFOLK COUNTY O ' i a l""T`7`X11'HEAL ICES 1 N • I
MAP OF PEBBLE BEACH FARMS
PERMI: ki+ ia,3a roto_ ()N, M:fr.7 -r0N F
. ORA W ' E
FILED JUNE II, IG75 FILE No. 6266 ,.s k ,ttt=;$
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SITUATE: EAST MARION! P
TO1N1`l: SOUT�IOLO 'ATE ! _n. �. f,5i' A.`. No), I -.Q.�7
SUFFOLK GOUNTY, NY APPRO. ;) _ . 41 �_� S
SURVEYED Oq-16-2004, li
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AMENDED 10-I8-2004 EXPIRES ��rz:F YEARS FTtia3
DA' .y OF APPROVAL
SUFFOLK COUNTY TAX #
test
1000-30-2-121
Owe\Ua
eroePrepared For: \ \G w
EXCAVATION INSpE,glor4
REURE2
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FOR
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Cross WayBY HEALTH �'ARYMEMY10• w -;c,II zappaia
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NOTES: f 4 . _ b' F S� ,.>0,-d IOn 2°oew.
Nen York State Education Lard'
E MONUMENT FOUND k d �'a e b
�, efanped>eal>holl t.camdered l be vdd o-ve
aa,„.
tertekatbn>indicated hereon>Ig iy that tb>
.urvy wm prepared b eCCardonc.rdth....
ZONING AS SHOWN IS FOR R-40 NONCONFORMING t . bU..... o.„raatw,a a.,,r.y>adapt.d
ey rhe new York srara n.>ocwnon of I'roi.eelorlal
SECTION 100-244 WITH MAXIMUM LOT COVERAGE OF 20% � Lindh v sad a.hesurvey Is �.ay
to the pxe1i ter Alan the survey b prepar.d
sd an H>bebl/to tt.titb conpgry 9ovr+�ea'
'^�.. �'' tai ;;"aro IetdYg hetibtbn Ibted fi.V.od
�i +� `' tton are on>1er to addnk.d b.tGtutlat. t
ELEVATIONS REFERENCE SUFFOLK COUNTY TOPO MAPS :
JOHN C. EHLERS LAND SURVEYOR
AREA = 21,614 5F OR 050 ACRES 6 EAST MAIN STREET N.Y.S.LIC.NO.50202
GRAPHIC SCALE 1"= 30' RIVERHEAD,N.Y. 11901
OM MEMENINIMININN NM 369-8288 Fax 369-8287 REF.-\\Hp server\d\PROS\04-263.pro