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ELIZABETH A.NEVILLE 0.1°� Town Hall, 53095 Main Road
TOWN CLERK P.O.® Box 1179
f . Southold, New York 11971
REGISTRAR OF VITAL STATISTICS � �
MARRIAGE OFFICER � ' �� Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER � ®d �@� 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. 2960 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 #R10-02-0159
Name Of Owner LEETEN, ELIZABETH
Mailing Address 1 746 BLAND POINT ROAD
City St Zip DELTAVILLE VA 23043
Property Address 1 400 ANGLERS ROAD
City St Zip GREENPORT NY 11944
Tax Map No. section 36.00 block 2 lot 17.000
Cross Street MEADOW LANE
Building Permit Number Cross Reference:
Issue Date: 12/26/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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,�•,O\,SOFFO`$ ; c Ci
ELIZABETH A.NEVILLE ����� Gi Town Hall, 53095 Main Road
TOWN CLERK ; y ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS i Southold, New York 11971
MARRIAGE OFFICER ?i � �� Fax(631) 765-6145
RECORDS MAkiAGEMF�, TTrOFFICER15 j'^7 '/® �' oi• Telephone (631) 765-1800
FREEDOM OF INFOR RATION gFFICER a * ,iso
e � southoldtown.northfork.net
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DEG 5 2002 { ,
OFFICE OF THE TOWN CLERK
-- �
ITOWNOFSOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: December 5, 2002
Transmitted herewith is a copy of application No. 3084 for a Cesspool/Septic Tank Construction
Permit submitted by:
Zoumas Contracting Corp for Elizabeth Lester
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:
�v
Signature
/63.2–-A/2 2—
Dated
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F ''� ���OLKG'� Wiz• • Application No. - 9.tai(
OFFICE OF T�TOWN CL..R-1 •�
TOWN OF SOUTHOLD •••• � '�`�•+ k'- 0� ✓
GI I7..PrTlJ A.P.O.BO 1 G•TOWN CLERK ? .;i i• nt 'f �.
` Construction
.BOX 1179
t NEW 1 97 p 1, .P r`r` �= Alteration
SQtTiOLD.N. ` cn gal' { •
�0 `� t 1"�� 0`�'••'• • $10.00 - Residential
Telephone �Sy 'Q� 84 •/•� $25,00 - Non-Residential
( 51 6) 765-1 S01 •.
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
•
• APPLICATION
•
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE /,. /(/0
APPLICANT NAME: p�� ��_ ��Y)fi �; ifGCOI'i' .
APPLICANT ADDRESS: .0: Box 361
' ��JaclingftiveridY 1179
SEPTIC X CESSPOOL yi •
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
c .t/V-e. 4
LOCATION MAP: Must be attached hereto before permit may be Issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION : • •
OWNER OF PROPERTY : SL) 2.A NUNO. L C�—� �C�•
OWNER MAILING ADDRESS: '7(f so RLA,JD poiNps1
0E_L-1-4.0 c.,L.(_ ✓` r\ 1mA a30y3
OWNER PROPERTY ADDRESS : q0 P040.
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TELEPHONE NUMBER OF CONTACT PERSON : JLi57o
TAX MAP NO. : Section Blocl<^
CROSS STREET : A-DOW Li—.
N `
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BUILDING PERMIT NUMBER CROSS REFERENC : • _
11111110.
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NimmkSignAppqcant=`► - ;:<i
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RECEIVED BY :
Town Clerk's Office •
DATE : Ps-
i .DATU1/1"NGVD , - IggEL LOCATION OF NATER MAINS
tOT AREA= 8,285 sq. ft. AND ADJOINERS WATER SUPPLY 6Y
OTHERS AND ARE NOT GUARANTEED.
F.F ELEV. 15.0
PLEASE NOTE
Minirnurn distance between well
ekistin and cesspool is to be 150 feet.
41E442 --' -----irn*I 'eir
w LANE. I (8.7) DweLNG
/'U
BC/C
I FD. Nor C wAR
PIPE S 80 50 RIGHT S3,
•CrEo)
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E I (10.0) 22'50"E F IrAr (10.6)
Le I 0 11.3.04• FD.
3 4 'IPE
w PI O PP + (12.0)
m PROP lei
:- O
I axi I tn DRIVEWAY I \0 Zo n
Ra 91' (n.t.s.) +� `f• ;�
3 well 1 N 35.0' (13.0) (13.0) cd 6 U
D b PROP FD.
IU' n DWELL PIPE m
0 = = _ w CL
O ) o
D
I TEST HOLE =.---=
de gross drive ) O I
O 0 ( O
O O Z
I Z (13.0) 30.0' (13.0) in .-•,
J prop. water service 35.0' o w
3 (1 1.2) PIPE (12.8) grFD. ass b post & rail fence on line (13.2) N o O —
I g3' I ' . g S 84.50'50°W 100.01' PIPE n co
'
. well DWELLING – WELL ro
Lu –• �
o a•well �''
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICEk u
TEST HOLE BY McDONALD GEOSCIEN PERMIT FOR APPROVAL OF CONSTRUCTION FOR A ® o•
•
8-12-2002 ` SINGLE FAMILY RESIDENCE ONLY a ,'
0 BROWN SANDY LOAM 0S 0
1' R/D D. -D/.J g
BROWN LOAMY SAND S S . DATE 11-2Z-OZ H.S. REF. N0. s
APPROVEDAllarl el c,
PALE BROWN FINE TO OARSE SANS 1 AXIMUM OF – .)L :DR00MS s,
8' F '�
BROWN CLAYEY SAND S EXPIRES THREE FROM DA ®FAPPR®VA!"_
11.9' .�
C;AVATION IN8 CT1ON. c3
WATER IN BROWN CLAYEY SAND S SANITARY SYS
16' . BY HEALTH CEPA" '_t, 'INP' ,
WATER IN BROWN FINE TO COARSE SAND SW ,n' o
23' r C •
THE O�� (OR DWD�ON!) SKIM MEM FROM TME STRUCTURES TO THE JOB No. 02-342 FILE No..060•F `�7
PROPERTY UN®ARE FOR A SPECIFIC PURPOSE NO USE AND THEREFORE ARE NOT . C-- tom.r%?
INTENDED TO DUDE THE ERECTION OF FEECIS. RETAINING WALLS. POOLS. PATIOS. �- C..l
PUMmA ARMs. moms TO ewLOINos OR ANY OTHER CONSTRUCnOM• SURVEYED FOR ZOUMAS CONTRACTIN r� h2
UNAUTHO ALTERATION OR MORTON TO WS SURVEY IS A VIOLATION OF SECTION n Co `r.t
720S THE NEW YORK STATE EDUCATION LAW. ---Z‘'\?',:,}--\-:-
?',:,} • -_ ?
GUARANTEES INDICATED HERON SHAL. RUN ONLY TO THE PERSON FOR WHOM THE SITUATED AT GREENPORT /0' c, ~'
SURVEY LS PREPARED .ANO ON HIS BEHALF TO THE TITLE°WANT. aovessiETtTAL ,\
MENCY NW LENDING INSTITUTION LIMED HEREON.AEC TO THE ASSIGNEES OF THE
�R STMITY N. "AWES 415 Nor TRAILRFE3ZreLADD
E TO InONAL ksTITUMN.s TOWN OF.SOUTHOLD – SUFFOLK COUNTY N.Y.
°R1+o u�D� awHERs.
COPIES OF
1" = 30' DATE 7-29-20000PIESOF THIS SURVEY MAP NOT REARM 11E LAND SURVEYORS IMO ,
D SEAL OR
2
E]NeDATE
ossEO SEAL SHALL NOT BE TO BE A vAUD TRUE COPT. FILED MAP No.
CERTIFIED ONLY TO: TAX MAP No. (REF ONLY) 1000-36-2-17 DISK 500
ZOUMAS CONTRACTING
SUNRISE ABSTRACT HAROLD F. TRANCHON JR. P.C.
LAND SURVEYOR
iG -14 �/ 1866 WADING RIVER–MANOR RD. WADING RIVER,
��Ja
NEW YORK, 9
. . LIC. No. 048992 631-929-4695
HAROLD F. TRANCHON JR. PENN. UC. No. 2115–E —