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HomeMy WebLinkAboutCrocos, John 0 yc JUDITH T. TERRY . Town Hall, 53095 Main Road Z ; P.O. Box 1179 TOWN CLERK a riot OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER Fax (516) 765-1823 Nt%� Telephone (516) 765-1801 :. 1 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 1015 R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X PERMIT ISSUED TO: Name : TELENDOS CONSTRUCTION CORP. Address 1 : P. O. BOX 2035 City St Zip ORIENT NY 11957 Descripton of Proposed Construction or Alteration CONSTRUCTION OF A SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM. APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES. Name Of Owner CROCOS, JOHN AND JOANNA Mailing Address 1 City St Zip GARDEN CITY NY 0000 Property Address 1 2110 GRANDVIEW DRIVE City St Zip ORIENT NY 11957 Tax Map No. section 14.00 block 2 lot 3.011 Cross Street PETTY'S DRIVE Building Permit Number Cross Reference: Issue Date: 6/30/93 Judith T. Terry Southold Town Clerk (TOWN SEAL) r / K JUDITH T. TERRY Town Hall, 53095 Main Road TOWN CLERK T P.O. Box 1179 REGISTRAR OF VITAL STATISTICS `� Southold, New York 11971 MARRIAGE OFFICER Q �' •�' 1i Fax (516) 765-1823 N1D�,.s Telephone (516) 765-1801 OFFICE OF THE TOWN CLERK! E C TOWN OF SOUTHOLD ' L Al 2 2 1111 TO: Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's DATED: June 22, 1993 Transmitted herewith is a copy of application No. 1044 for a Cesspool/ Septic Tank Construction Permit submitted by: Telendos Construction Corp. for John and Joanna Crocos 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. Thank you. Linda J. Cooper I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE DISAPPROVE Comments: f: ,1-1-#K 1, 'LLi//ter Signature 043, 3 Da t OFFICE OF THE TOWN CLERK ,,,,,,,, ," Town of Southold solAFFOUKc (` Judith T. Terry, Town Clerk � �l/� Application No. f Town Hall, 53095 Main Road !< Construction P. O. Box 1179 ; T Alteration Southold, New York 11971 cl / Tele hone =�0 �Q���' $10.00 - Residential p (516) 765-1801 : "l •' $25.00 - Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee $ DATE UNE .21 � �9`j3 APPLICANT NAME: TELENbc) CONST.KQCl C APPLICANT ADDRESS: � 0. $ox Di) O tEN% N k 1 , 1 lgS'�1 SEPTIC J CESSPOOL I/ DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION C©N)STRUeT A- 1 .ks o,2y 0-ovSE LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: OWNER OF PROPERTY: .3o1-1-1\) * ()ANN 4 C2g.ocos OWNER MAILING ADDRESS: A-"'ape CIT OWNER PROPERTY ADDRESS: f1 © G rci._,AviO vi OIRIEN, 1\1 .•-f. Ilecs7 TELEPHONE NUMBER OF CONTACT PERSON: TAX MAP NO. : Sectionj000 Block / 4 Lot S-- 3, CROSS STREET: ` E-r-Y tC `'9-\\J€ BUILDING PERMIT NUMBER CROSS REFERENCE: 2_S2SZ1U-8� Siure of Applicant RECEIVED BY Town Clerk's Office DATE: \ -� SUFFOLK CO.HEALTH DEPT.APPROVAL I Y / \ ! H.S. NO. 4 t V ► coil-ace r' / • --- -_ J. 4r 'de/! N.63'08.30"0 � '- Z79.56 L ste. o i Q ' fra,6d. Well (7 `� STATEMENT OF INTENT Q / b y .`:I I •• / THE WATER SUPPLY AND SEWAGE DISPOSAL Z ! , , SYSTEMS FOR THIS RESIDENCE WILL A. i C ` Z ^Q / CONFORM TO THE STANDARDS OF THE ; . ,O zr- I '-I • "� 1,' b 1 t SUFFOLK CO. DEPT. OF HEALTH SERVICES. • .at �i- 4� I - G , 2 �rJ U (Si DINC)� ZER1lt)S y tt• ;p y • •. APPLICANT ► I SUFFOLK COUNTY DEPT. OF HEALTH V 1 U 11 ti `1.. / SERVICES - FOR APPROVAL FOR L o I' CONSTRUCTION ONLY OCTI , r (.says ex�i.) o `� DATE: C 06wog I ?' • '' 1� i PLEASE NOTE 4 I s • o Min'Imum distance between werl H.S.REF.NO.: gl-�-SO p�� "Q.safr �� and cesspool is to be 150 feet, APPROVED �s4��/�" I ,‘,:j ____ 9 ._ r - Z 9't SUFFOLK CO.TAX MAP DESIGNATION: J• SB' •l! •s`� W. �- DIST. SECT. BLOCK PCL. piEcEavzo /000 • 14 ti 3.11 ' OWNERS ADDRESS. SO `.'o Dir:0,5 2e"vo s OCT 5 1992 .vlo,"r-i ,Fond S.C. DEPT. OF 7•ei. 3C3 - r.5-z6 NOTE, C FR4.t G '. f HEALTH SERVICES DEED: L. 1`,41,4 P. CY Dot. of Healiil $ 11j ._3 TEST HOLE STAMP ,li/c:i Or Lot No. area: ', 13.4 Y.ft. • • _GQA NO vi1 ; E s rs. " i" ..• ' fnik_ Co urft,/ r=';ic" tito. 70831 �A �1 'lisps-nu '' �' ;c 1XCl1 • N y t. i e ulcJel o/ ar+oQt.7old, .V• Y .7,sier,1Bd 0C-t.. Z, t992 ,r:a:.• � ! ,purveyed Gr Mrtr4 to: w 0 Nos - 12\SOS SEAL J >>L--/i'J C,r.�CZ0$ to.Box �.o3s • C)R VENT; N,,", 4967 NI • AlcMed auy. z!,/99z n '\. *Scale: X5'0'.' f RODERICK VAN TUYL.P.C. ! I. �` . V.—. LICENSED LAND SURVEYORS GREENPORT NEW YORK "Mone DOST nuun