HomeMy WebLinkAboutDickerson ELIZAEETH A.NEVILLE ��0 4. ;yu �0) Town Hall, 53095 Main Road
TOWN CLERK '=' P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER � 4�<`" 1�, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER = ®� ;'1°�, Fax
(631) 765-1800
FREEDOM OF INFORMATION OFFICER ,���
—es..�,i
OFFICE OF THE TOWN CLERK
SOUTHOLD ITAWIREIGASUERTEEMEEDSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2591 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 #R10-01-0103
Name Of Owner DICKERSON, DAVID & K MURRAY
Mailing Address 1 PO BOX 1114
City St Zip SOUTHOLD NY 11971
Property Address 1 NORTH BAYVIEW ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 79.00 block 8 lot 12.003
Cross Street NORTH BAYVIEW ROAD
Building Permit Number Cross Reference:
Issue Date: 5/30/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
oil' SOffatir 59
ELIZABETH A.NEVILLE ,e� �d Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
�y Southold, New York 11971
REGISTRAR,OF VITAL STATISTICS . ® �� Fax(631) 765-6145
MARRIAGE OFFICER ��
RECORDS MANAGEMENT OFFICER � �®� ,,.ss�2� ��® � Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER `z s' ����i�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: May 18, 2001
Transmitted herewith is a copy of application No. 2679 for a Cesspool/Septic Tank Construction
Permit submitted by:
Zoumas for David Dickerson and Karen Munry
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:
29_41
ignature
Dated
T
••'VVULKco App
llcation No. � ��
OFFICE OF THE TOWN CLERK ••• C� }'µms ti l/ •
TOWN OF SOUTHOLD • . fV� ,��:�� ": ` Construction______
,TOWN CLERK i .i :A`
ELIZABETH P.O.BOXY On
}-- �y- t : Alterati
P .BOX YO ,�, ; rri • .
sovrxoLD,A'EWYORIC 11971 . cr3;01i, • ' �' • $10.00 -Residential
_4•/,Q a4,,.," ���,•/ $25.00 -Non-Residential
Telephone _ ,j ,►
(516) 765-1801 • �. ......', .
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
_ APPLICATION
- -----------
for
•
CONSTRUCTION or ALTERATION PERMIT •
SEPTIC TANK or CESSPOOL
Permit No.
Fee •$ a D
DATE
APPLICANT NAME: '- t}I` ,��f k •
�;;•p,(y;:l�Ox 361
• APPLICANT ADDRESS:____^______-- �Ip6-•{gllapq 1
7
SEPTIC CESSPOOL
DESCRIPTION OF
PRO OSED CONSTRUCTION OR ALTERATION
• ,
4 't4 I(/ 10-/ ' AH _
LOCATION MAP: Must be attached hereto before permit may be Issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:' `
• . OWNER OF PROPERTY : b *cm .1.. biCkit..a� +
OWNER MAILING ADDRESS: ..0 !A ' / //
01/ c,0C'0 N•
• r $ � U/dote' "-''-=J '
OWNER PROPERTY ADDRESS: .a • j• ,
TELEPHONE
NUMBER OF CONTACT PERSON:
Q
TAX MAP NO. : Section.
B i o c{ __2, _-•_L:O t.....-G 4,,,,3-�-.,^ter�•^ �^
CROSS STREET : lio •
BUILDING PERMIT NUMBER CROSS REFERENCE:. , . VO ' .,
•nat - of • •licant1��
;:: :' Town. RECEIVED B Y:
ALILL-1,4-1---&-_-- ,
�:.�r• __________mak,,s Office
•
DATE:
SURVEY OF LOT 3
MAP OF
NORTH BAYVIEN ASSOG I AT1S N
FILED MARGH 13, 2001 FILE No. 10583
W_47_____E
SITUATE: BAWIEll
TOlNN: SOUTHOLD ®R
SUFFOLK GOUNTY, NY 4
•
H z.F . EV I/j_'�'p w
SURVEYED 03-31-0I �, �� V� �
SUFFOLK COUNTY TAX # -o- ap,9 lf�/ ®� j/�
1000-101-S-12.5 ,e . _ J
4„... '
l CERTIFIED TO: �tV •qO• Q�il ROap!
DAVID G. DICKERSON c` `r to
KAREN MURRAY
9
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!1,A CA NO 5� tai agency end londmg Institution osteal hereon,ono
MONUMENT FOUND. Aar a the aselg Bee tiv Ibndig wetltupan GertilIna_
Worts ore not transferable to odOdlonol Nslitutions
AREA = 200,304 SF OR 4.60 ACRES ��� ii ',; II ILJ I' I SUR
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GRAPHIC SCALE I"= 100' . 6 EAST MAIN STREET N.Y.S.LIC.NO.50202
RIVERHEAD,N.Y. 11901 REF.\\Hp server\d\PROS\01-139.pro
/ , 369-8288 Fax 369-8287
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