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Home My WebLink AboutCosmadelis, James (2) o��pF SO(/j�ol ELIZABETH A.NEVILLE '` O Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR OF VITAL STATISTICS G Southold, New York 11971 MARRIAGE OFFICER Fax (631) 765-6145 RECORDS MANAGEMENT OFFICERl Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER ycoum,� 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. 3388 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : JAMES COSMADELIS Address 1: P 0 BOX 481 City St Zip SOUTHOLD NY 11971 Descripton of Proposed Construction or Alteration -CONSTRUCT CEPTIC SYSTEM FOR NEW SINGLE FAMILY RESIDENCE -FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUNTY HEALTH DEPARTMENT Name Of Owner JAMES COSMADELIS ------------------------------ Mailing Address 1 P 0 BOX 481 ------------------------------ ------------------------------ City St Zip SOUTHOLD NY 11971 -------------------- -- ---------- Property Address 1 425 FOURWINDS COURT ------------------------------ ------------------------------ City St Zip SOUTHOLD NY 11971 -------------------- -- ---------- Tax Map No. section 88.00 block 6 lot 13.350 ------ --- ------ Cross Street ------------------------------ Building Permit Number Cross Reference: 47 Issue Date: 11/02/05 Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) o��pF SO�jyol ELIZABETH A.NEVILLE O Town Hall, 53095 Main Road TOWN CLERK l�[ l P.O. Box 1179 REGISTRAR OF VITAL STATISTICS N Southold, New York 11971 MARRIAGE OFFICER �Q Fax (631) 765-6145 RECORDS MANAGEMENT OFFICERtel'' Telephone (631) 765-1800 FREEDOM OF INFORMATION;OT+F `,ICER 0um, southoldtown.northfork.net 120 ��FICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: ----11�6utlhold Town Building Department 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 recommendations: APPROVE DISAPPROVE Comments: \ 4 r Signature Dated o�Og�FFO�,�co ELIZABETH A.NEVILLE ov -Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR OF VITAL STATISTICS W T Southold, New York 11971 MARRIAGE OFFICER Oy �� Fax (631) 765-6145 RECORDS MANAGEMENT OFFICERTelephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER �O'� �a 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.35 3-7 Permit No. Applicant Name 'S'AWles COSM A'fO a Li % Applicant Mailing Address Po GOX. W st Sark N DLo t.-I"-) 1tcr 1 l Septic Tank or Cesspool Brief Description of Proposed Construction or Alteration Co%%*r tjc,'T CCP'"(G. �O�Z 1�1��y SIMGt.L. �=A�'►l�y+ l?sS��nC� Location of Proposed Construction/Alteration: Owner of Property: 3 PrM.tS CdS M A t�E L S Owner Mailing Address: PO 9000- 1-1%l %DJT N CX-0 NV 114-11 Owner Property Address: LATS F0M\ 4 i N OS C-7. %OOT"CL-0 tol 1141-1) Name and phone number of contact person SIM (0w4401&Li S SS-2)41. Tax Map No:)000 Section M Block 06 Lot 13.35 Cross Street -rift. E SPLs r! r4 DP— NOTE: LOCATION MAP MUST BE SUBMITTED Wjl# APPLICATION. NEW CONSTRUCTION REQUIRES SURVE WITH T D P NT APPROVAL Si tore App cant Date Received by: I am famlNar WIM the STANDARDS FOR AND CONSTRUCTION OF SUBSURFACE DISPOSAL SYSTEMS FOR SINGLE FAMIL 'C and wlll abide by the conditions set forth M V 0� permll 10 construct. The locations of wells and cesspools shown hereon are from. field observat 1; 39. and or from data obtained from other Q 0 Ns LOT S1 . G� r�WELLING (Public water) M to d 138.81' 0° E. I 81 u► °59.0 _- !-- r � N. fna� - O' WA E gERy10E. lui EASEMENT it °7'y'" W/,s O " 3o 1 n tr 0 ip 1 1 a .S (4-0 (631)4 -oZk LO UVUMBERS ARE REFERENCED TO MAP OF ' ANGEL SHORES FILED IN .THE OFFICE k OF THE SUFFOLK COUNTY CLERK AS MAP NUMBER 9729 110 AREA - 37,444 °bF�� sq. wver, - ANY AL TERA TION OR ADDITION TO THIS SURVEY IS A VIOLA TION T OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. EXCEPT AS PER SECT/ON 7209 - SUBDIVISION 2. ALL CERTAFICATIONS COPES ThEREOF OAC y IF SHAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR WHOSE SIGNA TURE.APPEARS HEREON. ADDITIONALLY TO COMPLY 07TH SAV LAW TERM 'ALTERED BY ' ELEVATIONS ARE REFERENCED TO AN MUST BE USED BY ANY AAV ALL SURVEYORS UTILIZING A COPY ASSUMED DATUM. ,FF ANO r ER SURVEYOR'S MAP. TE WOVAL AGE SSIDENCES 'n and on the 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 SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES PERMIT FOR APPROVAL OF CONSTRUCTION F+Oi�A 4 Se• �� LE FAMILY RESIDENCE ONLY <� `�Q•F DATE o HS .N4• APPRO D ------ 1 FOR MAXMIUM OF BED OMS a EXPIRES THREE YEARS FROM DA OF APPROVAL �/ s`SBte \0///svt LOT ®/ i �'`0 eJ0' o P Dh _0 OF NEW), 1 ,46 5 / Y.S. 6 ` IMECONIC EYOC. V17 (63/) 765 - 5020 F o P. 0. BOX 909 L4ND S 1230 TRAVELER STR SOUTHOLD, N.Y. 11971 05 - ?0