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ELIZABETH A.NEVILLE ��e� ��, Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
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MARRIAGE OFFICER %, ®s� p��I Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER -,_- ® o��,��'l',i Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2767 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 #R10-02-0011
Name Of Owner ZOUMAS CONTRACTING CORP.
Mailing Address 1 PO BOX 361
City St Zip WADING RIVER NY 11792
Property Address 1 WELLS ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 70.00 block 3 lot 22.000
Cross Street JERNICK LANE
Building Permit Number Cross Reference:
Issue Date: 3/20/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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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 % i Southold, New York 11971
14!MARRIAGE OFFICER `` ®� '1Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ? ®1 ii Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER - --�,r��� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
`i, FEB 2 8 2002
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: February 27, 2002 Tn " r ;
Transmitted herewith is a copy of application No. 2856 for a Cesspool/Septic Tank Construction
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 location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments: %, ,-
Signature
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3/.2.--/p zDated
•
••••qV OUre; z . Application No. ��
OFFICE OF TIE TOWN CLERK • ••
•
TOWN OF SOUTHOLD ••• ,fit k, ; Construction
rF t7� !T{A.NEVrI 1E,TOWN CLERK : r.i ''�• t iy,' i
71 ty •.
P.O.BOX 1179 i 11 ;, ��, I Alteration
SOUTr.OLJ,NEW YORK I1971 Z `,I xtt ' •
�Y cra `•' / (••' • $10.00 - Residential
Telephone 0 y 4 0 ,'••� $25.00 -Non-Residential
(516) 765-18011 ✓
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
•
APPLICATION
•
for
•
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE 3- a: 0 2----
APPLICANT NAME: .PUMA5-.66ffiA-6-TiNG-C-efrEI •
ADDRESS: •' ?;;p,O:;•Box361
APPLICANT ��fadiflgRiver,-td ' II 9
SEPTIC r CESSPOOL •
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: •
•
OWNER OF PROPERTY: ZOUMAS CONTRACTING CORP.
OWNER MAILING ADDRESS: POBox 361
Wading River,NY 11792 •
OWNER PROPERTYADDRESS : Lo � 9O Wt / gAO
TELEPHONE NUMBER OF CONTACT PERSON: 902-7 -ref 370
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TAX MAP NO. : Section Lot� „.� -. �
CROSS STREET : &Q.12-/V“Lk- 6-ft-i•-)e - '
BUILDING PERMIT NUMBER CROSS REFERENCE: •
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:: BY RECEIVED Gly—
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Town Clerk's Office
DATE :
I/�1
1—I
UM AREA= 40,786 sq. ft.
F.F. ELEV.= 23.0
GAR. ELEV.= 21.5
WELL GREATM DWEW NG 1HAN 50'
DWEWNG — PUBUC WATER
_ istingwaater•�ain_
WELLS ROAD "C- B NT.
(�,.) S 56'52'40"E 100.00' :9.7
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175.00"
LOT NUMBER e
VAGANT
THE Ores (OR OMINOUS) MOM HEREON MOM THE STRUCTURES TO THE
PROPERTY WES ARE FOR A SPECIFIC PURPOSE AND USE ANO THEREFORE ARE NOT JOB No. 01-617 FILE No. PECONIC DEVEL CORP.
MENDED TO GUIDE THE ERECTION OF FENCE REDINWG W.41.% POOL% PATHOS,
PUYr"N°MEAS.ADDITION TO BUEDNGS OR ANY GTIER CONSTRUCTION. SURVEYED FOR
utwmnarzeo ALTERATION OR ADDnION TO THE SURVEY TS A HlOLATION Of SECTION LOT NUMBER 9
720S OF THE NEW YORK STATE EDUCATION LAW. MAP OF PECONIC DEVELOPMENT CORP. AT SOUTHOLD
GUARANTEES INDICATED HERON SHALL RUN OILY TO THE PERSON FUR WHOP TIE
SUINEY I5 PREPARED.Mo ON HIS ®ERS To TIE TTITF CIMANY. GOVERNMENTAL SITUATED AT SOUTHOLD
AGENCY AND LDIDNO NSRRJNON LISTED HEREON.AND TO THE AiCI9NFFS OF THE
LENGIIG INSTITUTION. GUAFIVITEES ARE NOT TRAwETAAELE TO ADDITIONAL I STTTIJIIONS TOWN OF SOUTHOLD — SUFFOLK COUNTY N.Y.
on SUMIOWIT O NEJO.
DOPES OF THIS SURVEY NAP NOT BEARING THE LAND S R tYOR.s INKED SEN.OR SCALE 1" = 50' DATE 12-20-2001
MOS7ED SEAL MAIL NOT BE CONSIDERED TO RE A AULT TRUE COPY.
FILED MAP No. DATE
CERTIFIED ONLY TO: TAX MAP No. (REF ONLY) 1000-70-3—P/022 DISK 500
HAROLD F. TRANCHON JR. P.C.
LAND SURVEYOR
f -�� 1866 WADING RIVER—MANOR RD. WADING RIVER,
NEW YORK, 1T792
N.Y. LIC. No. 048992 631-929-4695
HAROLD F. TRANCHON JR. PENN. LIC. No. 2115—E