HomeMy WebLinkAboutDormurai, Christine es
ELIZABETH A. NEVILLE �� Town Hall, 53095 Main Road
TOWN CLERK ; y P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �+' 4,1��� Southold, New York 11971
MARRIAGE OFFICER G , Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER ".y'f1Ol
01 .�* ��. Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2222 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : ZOUMAS CONTRACTING CORP.
Address 1 : PO BOX 361
City St Zip WADING RIVER NY 11792
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-99-0215
Name Of Owner DORMURAI, CHRISTINE
Mailing Address 1 1549 JONESTOWN
City St Zip WINSTON-SALEM NC 27103
Property Address 1 245 HICKORY STREET
City St Zip SOUTHOLD NY 11971
Tax Map No. section 54.00 block 9 lot 5.000
Cross Street PINE ROAD
Building Permit Number Cross Reference:
Issue Date: 1/14/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
,„-
.° Co
ELIZABETH A.NEVILLE Town Hall, 53095 Main Road
TOWN CLERK % o • % P.O.Box 1179
REGISTRAR OF VITAL STATISTICS �y /',� Southold, New York 11971
MARRIAGE OFFICER Fax(516) 765-6145
RECORDS MANAGEMENT OFFICER �f� �� �1� Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER - '� ` .'�
•
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: December 27, 1999
Transmitted herewith is a copy of application No. 2310 for a Cesspool/
Septic Tank Construction Permit submitted by:
Zoumas Contracting Corp. for Christine Dormurat
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:
ignatu
/ 2--/ 41
Dated
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OFFICE OF THE TOWN CLERK ,t'
COV (
TOWN OF SOUTHOLD ,44� �OG� Application No. 2 /
EUZABEIB A.NEVI LE,TOWN CLERK ,
P.O.BOX 1179 Construction
SOUTHOLD,NEW YORK 11971s 73 o r=Tt
Alteration
Telephone Q`C',' • $10.00 -Residential ,
(516) 765-1801 1 ,�'' $25.00 -Non-Residential
-.. „„40''''„40'
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for .
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. )aa ..____ •
Fee $
DATE J Z /6)- ) 7Q/�Q
APPLICANT NAME: ------�_
ZOUMAS coN�ACTINC conr.
APPLICANT ADDRESS: �P.O•Box361
., ,, WaJTutg River,NY 11792
SEPTIC CESSPOOL /
DESCRI TION OF PROPOSED CONSTRUCTIO R ALTERATION
rn-eil(-y Qwe Ill
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTN OR LTERATION:
' • OWNER OF PROPERTY: G1 N, iV O 6-Ati ltA-7
1, • ONTRAC G Co 1? [6(11 eo
OWNER MAILING ADDRESS: P,Qenx? ,� a,11�
a Ing River, NAY 11792
OWNER PROPERTY ADDRESS: ZOU a ii5 if k i<b4-� J
We�l,,��-p�,�},,�_11792 Q �,/
TELEPHONE NUMBER OF CONTACT PERSON: !—1 S '
TAX MAP NO. : Section s11 Block 9 Lot
CROSS STREET: \moi Ne: d
BUILDING PERMIT NUMBER CROSS REFERENCE:
/ . c .,_..,,,_.
nature o*'•.= 'cant
RECEIVED BY t_...---6_,(.0-6--/2-1---c
Clerk's Office
DATE: dy,
77 c-
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WELL
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VAC. ANt- 41 h` iZ In
•LOT AREA = 13,000 sq. 11. ,
F F ELEV= 4( .o'
GAR ELEV s 44.0' I
(40.o) HICKORY STREET (42.0) o I-
In
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own. S. 42'10'20" E. 100.00' fio�ok
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TEST HTE mon.. •moa.
by McDonald eosclence N. 42'10'20" W. 100.00' (44 6
I0 - 8 - 1999
o — Brown sandy loom OL
2.5Brown loamy clayey sand SC VACANT
Brown day.y sand SC -
1I• --- SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES.
PERMIT FOR APPROV UOF CONSTRUCTION FOR A
Brown sandy clay and clayey sand CL a SC
SINGLE FAMILY Tge EWERS WELLS AND CESSPOOLS BY
OTHERS D ARE NOT GUARANI:Eg.o
DATE Il-I(;--C1q HS REF.NO. l<l0- -0? 1..5 ;� a v,
_ �0 c
/1-7.- APPROVED — "' o ,�x,
/ Mst.r brown clayey sand SC FOR MAXIMUM OF _ ODMS No rn
n `I o
43.— rnr- ca =°,,m
wafer in brown tine to medium sand SP EXPIRES THREE YEARS FROM DATE OF APPROVAL x
`icr, 'v �C
4 rTtF,t =. c)rn
�� REVISED 11 - 9 - 1999 a< W _a
Ht OFFSETS (OR IMENSIONi) 6UAIANTEES INGICAIIA new..Los JOB NO. 99-496 FILE NO.3%6 g -<
,HOWN HEREON FROM THE SHALL RUN ONLY TO THE PEIEOI �ry/��
ITNES�AREES TO POE ATHE PROPERTY POR WHOM DIE l I FIC PUT- PARED, AND ON SURVEY APS 10noel V/4 A 1 t,-kI INSPECTION REQUIRED
NMINOT U� AND T. „E t Dov FOR SANITARY SYSTEM
NMI DRUM 10 GUIDE TI! TM. NANCY AND IESJDMK' IIJlTI
KKTION OL Pumas, RPLANTING THEION LUTED HEREON,H, AND BY HEALTH DEPARTMENT
NAtli, POOLS. PATIOS, PLANTING THE ASSIGNEES Of THE (ENDING
AREAL ADDITION TO BUILDINGS INSTITUTION. UARANTEES ARE
-*AWECOSI COMMOTION. - NOT TO ADDITION/LL
INSTITUTIONS OR %USSEOUENI SITUATED AT SOUTHOLD
1NAUTNORIZID ALTERATION OR OWNERS.
1DDA10N W THIS SURVEY IS A TOWN OF SOUTHOLD- SUFFOLK COUNTY N.Y.
IOLATION of S ICTTON MO OP WPM OF 1HIE DAVEY MAP NOT
HE NEW YORK STATE EDUCATION SEARING THE LAN) SURVEYOR'S
ow, INIONS SEAL OR EMIOSSED SEAL SCALE 1" = 30' DATE 9-29-1999
SHALL NOT RE CONSIDERED TO •
FILED MAP NO. DATE
GUARANTEED ONLY TO .0P�_ of 'New rpR TAX MAP NO. 1000-54-9-5 (REF. ONLY) DISK 207
5 F� TRAN0 + HAROLD F. TRANCHON JR. P.C.
Ove oy LAND SURVEYOR
c N *
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(/ ��� '_'.' i '1866 WADING RIVER-MANOR RD. WADING RIVER,
J �^ .� /`'``�' i0 9Z OQ' NEW YORK, 1 1 792
1 #41'
.
HAROLD F. TRANCHON JR. •
Lk t $1195E 516-9 2 9-4 6 9 5