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ELIZABETH A. NEVILLE ��� "� _ Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS % Southold, New York 11971
MARRIAGE OFFICER `�®�i � �, Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER ��® i� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER t; t
OFFICE OF THE TOWN CLERK
SOUTHOLDTTT pfJ,fNSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2667 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 #R10-01-0197
Name Of Owner ZOUMAS CONTRACTING CORP
Mailing Address 1 PO BOX 361
City St Zip WADING RIVER NY 11792
Property Address 1 2030 KENNY'S ROAD
City St Zip GREENPORT NY 11944
Tax Map No. section 53.00 block 4 lot 44.006
Cross Street SAGE SPUR
Building Permit Number Cross Reference:
Issue Date: 10/18/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE /0, . '4 # ; Town Hall, 5309 Main Road
TOWN CLERK ® �`5� 5 P.O. Box 1179
REGISTRAR OF VITAL STATISTICS { r} Southold, New York 1197.1
MARRIAGE OFFICER : op
fw `��'1� Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER ® E� $ 1 i1. Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER _ `is' ���
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. 2758 for a Cesspool/Septic Tank
CONSTRUCTION/ALTERATION Permit submitted by:
Zoumas Contracting Corp
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 to tion 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.
"e41-‘er 4P:
Signature
71-7 d�
Dated
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"„App!(cation 'No.2!-7.5:a' `;'°
omcEOFTHET0 CLERIC �� _
.' O ,,144".,....N. Construction
,-- TOWN OF SOUTHOLD
ELIZABETH A.P.O.BOX
1119 N CLERKr a '?' .,, .,
• •;, ,,� . Alteration ,
P.O.BOX YO • tea .fy -c. " .� ' •t•.. rri
sovrxo�,�'�wyoRxlt971 %V 'n xis , i'•,x `�0 Residential
. y Ia,, � . • $10.00
Telephone .�DQ' 4u•..���'�� •
$25.00 'Nen-Resfdentfal_ ,
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(516) 765-1801 •• ••�•� ,
TOWN OF SOUTHQLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT - ,
APPLICATION „
• for • .
CONSTRUCTION or ALTERATION PERMIT •
- , , , - _ -
•SEPTIC TANK or CESSPOOL •
Permit No.____
Fee $
DATE
•
1 • ,
APPLICANT NAME - oui` s,.RNT `) • ' ,.$.,„.,.,,_i,
::;.;1.1,P,U:;•Box 361
APPLICANT ADDRESS: •• �tadin! RivertJ - , .- •
CESSPOOL lON”
SEPTIC '
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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.; :;':rti„<; : . 'r," ,i• ',,1 - erm�I. 'mu . -be fs_sued. :,,E-P,: Y,- .:F.-.. ,-,e. •t,
~ LOCATION MAP: Must be attached
hereto before "p aY.
LOCATION OF PROPOSED •CONSTRUCTIO•Np-O-R-A.LTE.RATI0.N: s, •
• • OWNER O F PROPERTY . C� t �e, .r` � .— �;' �'_1 ,< a
• OWNER MAILING ADDRESS. • ,, , : :' i, '� 'ive., ,. .
IJJO' - .rK•.n NYz tia�acrT�g.�.w ,,,,. .. r ,.-Al l ' ,
• OWNER PROPERTY ADORES : - _-
F -CONTACT PERSON 09
____/_1----' -'21 -7°—
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TELEPHONE NUMBER 0 _ ;;;' '''. ,'
Lots/.; °.. �-� .,:.:. ...^....e'"
tion B,Iock, _ - ---� ;;; ... l;
TAX MAP NO. . Sec _______. ._._ ; '4 ''•'° ;: ;r+p;,:
CROSS STREET . .'-':.- 1:; :.'
BUILDING
NUMBER CROSS REFERENCE: :J.;
, -,. r-
BUILDING PERMIT = .. `•,
, _ ffcant.>: .;F",. >P.. ':;°",yk:'}.741 � 1;,f `_
�.1',.•• RECEIVED BY : T/ " n Cleric's Office
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LOT AREA= 40,000 sq. ft.
't� F.F . ELEV.= 17.5
GAR:"1`ELEV.= 15.0 \\
DATUM N.G.V.D.
LOT NUMBER 11
DWELLING – PUBLIC WATER
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existing water main
(10.1) KERWIN BOULEVARD (11.7)
S 43'09'40"E 160.00'
(10.1) 1 (11.7) 137.00' 1
ZIc--- t; R= 25.00'/
o S . r L= 39.27'
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to -.- 0. ..,
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al
o al 2. o
ni (14.5) (15.0) Ni
0 45' y covered poach ¢
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garage
o PROP. I b
rg DWELLING — n
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O (15.0) •sNj.e' (15.0) 50' - a
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0 Pi SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES m 0
c" cli
a PERMIT FOR APPROVAL OF CONSTRUCTION FOR A m m
A SINGLE FAMILY RESIDENCE ONLY m
DATE 9?1d,,,,. H.S., i F. ,'a �r"-Qf
APPROVED Lr_• ,
FOR MAXIMUM OF BEDROOMS --
' - ; --
N i—I
a EXPIRES THREE YEARS FROM CATE OF APPROVAL • o : ' y
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0 - =-
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EXCAVATION INSPECTION REQUIRED ,. _-- -,
FOR SANITARY SYSTEM
BY HE pm ��� 3
(14.4) (14.0) --- ; c ,-
N 43'09'40'W 160.00'
--i:.,.> CO -.
NOW OR FORMERLY SAGE ESTATES – VACANT
THE OFFSETS (OR DIMENSIONS) SHOWN HEREON FROM THE STRUCTURES TO THE
PROPERTY UNES ARE FOR A SPECIFIC PURPOSE AND USE AND THEREFORE ARE NOT ,JOB No. 01-426 FILE No. AUGUST ACRES
INTENDED TO GUIDE THE ERECTION OF FENCES. RETAINING WALLS, POOLS, PATIOS,
PLANTING AREAS, ADDITION TO BUILDINGS OR ANY OTHER CONSTRUCTION. SURVEYED FOR
UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION LOT NUMBER 4
7206 OF THE NEW YORK STATE EDUCATION LAW. MAP OF AUGUST ACRES SECTION 1
GUARANTIES INDICATED HERON SHALL RUN ONLY 10 THE PERSON FOR WHOM THE
SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL SITUATED AT ARSHAMOMAQUE
AGENCY AND LENDING INSTITUTION USTED HEREON, AND TO THE ASSIGNEES OF THE
LENDING INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE TO ADOmONAL INSTTNDONS TOWN OF SOUTHOLD – SUFFOLK COUNTY N.Y.
OR SUBSEQUENT OWNERS.
COPIES OF THIS SURVEYMAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL SCALE 1" = 40' DATE 8-28-2001
EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BEA VALID TRUE COPY.
FILED MAP No. 9107 DATE 6-3-1991
CERTIFIED ONLY TO: TAX MAP No. (REF ONLY) 1000-53-4-44.6 DISK 500
HAROLD F. TRANCHON JR. P.C.
LAND SURVEYOR
I' 1866 WADING RIVER–MANOR RD. WADING RIVER,
�� F �,tl�~ r I un--- NEW YORK, 11792
(', N.Y. LIC. No. 048992 631-929-4695
HAROLD F. TRANCHON JR. PENN. LIC. No. 2115–E
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