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ELIZABETH A.NEVILLE d= ; Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS % Southold, New York 11971
MARRIAGE OFFICER efi ` ;st Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER ® . �� Fax
(631) 765-1800
FREEDOM OF INFORMATION OFFICER - - ����
OFFICE OF THE TOWN CLERK
SOUTHOLD TOONMoartaTlatiiniSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2668 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 #R10-99-0243
Name Of Owner MCGILL, WILLIAM M
Mailing Address 1 2 EDWARDS STREET, APT 1C
City St Zip ROSLYN HEIGHTS NY 11577
Property Address 1 525 FOUR WINDS COURT
City St Zip SOUTHOLD NY 11971
Tax Map No. section 88.00 block 6 lot 13.036
Cross Street WATER TERRACE
Building Permit Number Cross Reference:
Issue Date: 10/18/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
Aim
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ELIZABETH A.NEVILLE /kreifz �
d Town Hall, 53095 Main Road
TOWN CLERK ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS `' 0 M1 °� �� Southold,New York 11971
MARRIAGE OFFICER ��r,� ;<✓ � �1� Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER "�01% 2 ��®�i� Telephone (631) 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: September 27, 2001
Transmitted herewith is a copy of application No. 2759 for a Cesspool/Septic Tank
CONSTRUCTION/ALTERATION Permit submitted by:
Zoumas Contracting Corp for William McGill
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: Maintain required setbacks from adjacent wells,buildings, property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED.
0, r, a /At e
rA(Ael,
Signature
7/1'7/1/
Dated
£ -44
I - 3
. 27�/
.,,�60V OLxca .z Application No.
OFFICE OF THE TOWN CLERK /' ��((
TO�,lI20FSpUIHOLD 0� • r'' r ,�T �j1 ; Construction_______
ELIZABETH P.O. OX 11 9 CLERK ; i-(: )1r �` � r ;
}" Alteration
P .BOX 1179 ;
sotrrxou�,h'�wyoRx 11971 �� -Residential
:1.y '� ' r •' .,C • . $10.00
Telephone =_� Q�( ,�, � ��,�►' $25.00 -Non-Residential
(516) 765-1801 • •: „ n''
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee •$
DATE / 2 1 "
APPLICANT NAME: _____nu ieON ' `" ' • : •
;;�„P.p°.gox 361
APPLICANT ADDRESS: eVadip Ive ,-..-- -
SEPTICJCESSPOOL
DESCRIPTION OF PROPOSED CONSTR • CTION OR ALTERATION
h IL . 1 '0 il
a
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTI•N OR ALTERATION: / ��
OWNER OF PROPERTY :
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OWNER MAILING ADDRESS:
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' OWNER PROPERTY ADDRESS: '_A 1,...m.:,,,..� "'` �
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5Q F j - _ ..4_ __ • i 1 '
TELEPHONE NUMBER OF CONTACT PERSON: ���
Block Lot I � - -_^^~
•
TAX MAP NO. . Section� ._ --
CROSS STREET
BUILDING PERMIT NUMBER CROSS REFERENCE: .
. /
If !F-141111P.
. �.
..�'._
ignature o . !cant
•
;::'.g.. .' RECEIVED BY Town Clerk's Office .
DATE:
r
6 •
•
•
SURVEY OF LOT #34 N
"MAP OF ANGEL SHORES° SEPTIC DETAIL
FILED 8-23—q5 AS #a—i2a w _ �- E not to scale
SITUATE: SAYVIEW ' i ;i
TOWN: SOUTHOLD 04
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SUFFOLK COUNTY, NY '��"' ___ - ,, ,
SURVEYED II-10-99 •
SUFFOLK COUNTY TAX #
1000 - 88 - 6 - 13.36 •, •,
CERTIFIED TO:
JNILLIAM M. MGGILL TEST HOLE
FIRST AMERICAN TITLE
INSURANCE COMPANY
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Ton
Sond
SUFFOLK CO' T
COUNTY DEPARTMENT MEN 1 OF I IiAL1:15ERV ICES
PERMIT FOR AM1'F'A'>'•C+VAL O+1<CCINSt T UCTI`N POR A 7 5
swam:re.any...7 arisrasmat ONLY
DATE 1 l S-q ;-IF REF.NO. 0 9. /
APPROVED %
FOR MAX/MUM OF_
BEDR -.4S
&°',FIRES iintra YEARS FROM DATE OF APPROVAL 11 5
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■ MONUMENT * t i} ' t♦
o PIPE • 4` ,c'-LL: Q•
�,A !50202 -koi' JINN C EHLERS LAND SURVEYOR
AREA = 30,209 SF OR 0.69 ACRES ``'.FC)LAND SJi�0I 6 EAST MAIN STREET N.Y S.LIC.NO.50202
i
GRAPHIC SCALE 1"= xx' "'`� RIVERHEAD,N.Y.11901
369-8288 Fax 369-8287 REF.-TIGER\PROS\99-293