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ELIZABETH A.NEVILLE i• � Town Hall, 53095 Main Road
TOWN CLERK ® P.O. Box 1179
REGISTRAR OF VITAL STATISTICS � +1i Southold, New York 11971
MARRIAGE OFFICER �� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER �__�® Alig •• 'i� Fax
(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. 2941 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 #R10-02-0178
Name Of Owner POHANIS, LUCAS
Mailing Address 1 8 COTTONTAIL ROAD
City St Zip MELVILLE NY 11747
Property Address 1 160 DAISY ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 106.00 block 8 lot 27.000
Cross Street DOGWOOD LANE
Building Permit Number Cross Reference:
Issue Date: 12/23/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
J .
ELIZABETH A. NEVILLE /80
OG# Town Hall, 53095 Main Road
�
TOWN CLERK r4 , P.O. Box 1179
REGISTRAR OF VITAL STATISTICS % i Southold, New York 11971
MARRIAGE OFFICER `� �,iL �����, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER �__�Ql �a�iii Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER �'� southoldtown.northfork.net
E f P� , ` _ ';s ` n i; OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
h ', �,
NOV 1 2002 ;
TO: ___S-outholid Town Building Department
1, •
T u�a�p;; ., . ' ;,..,gip
R4�V LL:2- -1 Lihda . Cooper, Southold Town Clerk's Office
DATED: November 7, 2002
Transmitted herewith is a copy of application No. 3060 for a Cesspool/Septic Tank Construction
Permit submitted by:
Zoumas Contracting for Lucas Pohanis & Michael Georgis
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 YYY
r
Comments: � � - - r/
' --r..4..--,,
fce , Ems'
Signature
/VO 6/,Z.
Dated
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n
OFFICE OFTHE TOWN CLER.F: OLA/ Application N o.
TO\tiNOFSO(1THOLD �••••O5 „w:A%
3060
Construction
r:rr�� rC}{A.1�FVrLir:,T01VNCLE•R}, ,�•Q;� '� ;� ,(.,-""?41.
P.o.BOX 1179 A ` p", t 4 Alteration
r NEW 1!97! r ''�( ` 171
SOUi"r?OJr 1`� u 'b`l ' 1 •
r' - Residential
Telephone 0� �►�►• $25.00 -Non-Residential
(516) 765-1801 I m.
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANI< or CESSPOOL
Permit No.
Fee $
DATE // k"
APPLICANT NAME: ---- ••Z•OU�C �-. �j -• }{iC-C-4ft' .
=��:p,p:�,Box 36l
APPLICANT ADDRESS: ,'j •��fadirig- ive7NY 11
SEPTICCESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION .
y Y
LOCATION MAP: Must be attached hereto before permit may be Issued.
LOCATION OF PROPOSED CONSTRUCTION) OR ALTERATION:
• OWNER OF PROPERTY : LOCO-- PO OO n' I' i(' � µcr/3
OWNER MAILING ADDRESS: S CO 4-J0/v4-14-IL r0A-1)
I(Yl &1-u i u.(— N,•V• /l -2(P)
OWNER PROPERTY ADDRESS : D Sy L- f� / /J
•
TELEPHONE NUMBER OF CONTACT PERSON: %Q
a5—YS7d
TAX MAP NO. : Section_ ___ _Block _._ ..Lot,. a,,Z,,.,,,.,.,� ....... •
CROSS STREET : �cf,--L.1..' 00 :D. LA-N-)(2---- . •
BUILDING PERMIT NUMBER CROSS REFERENCE: •
�` �. ant `,n , .:, ; .; • :,
•
•
'—. Signature of,' • p .
RECEIVED •_LkZ-..e1-Zs _____—_,-----
•.:,:, . Town lerl<'s Office
DATE: (/ 7 0
--- -
t ,. LOT AREA= 20,001 sq. ft.
• F.FL ELEV.= 46.5
VACANT DWELLING - PUBLIC WATER GAR. ELEV.= 45.0
LOT NUMBER 20 X LOT NUMBER 19
FD. N 71'39'20"E 105.27'
MON. ' X chain link fence 0$13'N.
X —
post do roil
(45.7) (46.1) X
fence
on fine
4 s E ~Jr.l' . .•I.It"i l-T.., ^t, ! .f,`: , .i5• (,-.'.h,5 i 1'�‘>L'..i V AL-Z,5
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ellis itcll'l .t' ' .' ' ,,Gile:70d I 8
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6 2, (7,- ! IEXCAVAMION1NSNECTION REQUIPtEO —I
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C % 0 1 I ' (45.0) ' (45.0)
R�77
45.0
0 -4- 0' 41M•111111• 111111111141cm
w
* . 1 2 58.8' -
II
I I i-- � o
PROP.
I I O DWELLING o
garage I 20'--
caoopo
coverrh
• W
(45.0)i 3I (45.0)
� v
I
a '
1 I p —
, R=28.3
2 I m L=40.99
(43.1)1 I (41.8) 85.00'
•
MON. S 71'39'20"W 105.27' MON. L`7 (tvy
--
Fri o c./) `r i
(42.3) DAISY ROAD (41.1) ur -0 `j A
rt -- CD .':rri
existing water main L.--” -''-
NOTE: LOCATION OF WATER MAINS r 't ' rri
AND ADJOINERS WATER SUPPLY BY .) - c:.�
OTHERS AND ARE NOT GUARANTEED.
LOT NUMBER 43 LO1 U o R
1HHE of RICHT OF WAYS ANo OR s VACANT DWELIJ — PUBLIC WATER
OF FECORIL F ANY. NOT SHOW NE NOT OWRNI7 ED.
THE OFFSETS (OR DOIENSIOHR0 SHOW HF7N N FROM'DE STRUMMER TO THE
PROPRTY LINES NE FOR A SPECIE PURPOSE AND UE AND THEREFOREARE NOT JOB No. 02-388 FILE No. SUNSET KNOLLS
DEEMED TO MME Tr E» Cr FE= WADI=CALLS. POOLS. PATIOS,
PUWT W ARM. ADDITION TO BUILDINGS OR ANY q HER CONWIAUCTO L SURVEYED FOR ZOUMAS CONTRACTING
UNAUTHORIZED ALTERATION OR ADDITION TO THE SURVEY IS A VMONATION OF SECTION LOT NUMBER 34
7209 OF TIE NEN YORK MOE EDUCATION WE
MAP OF SUNSET KNOLLS SECTION TWO •
WARANTE3 INDICATED SONi°IN ONLY TO THE PERMFOR WHOM THE SITUATED AT MATTITICK
SURVEY IS PRFFNiiD.•AND ON HIS BEHALF TO THE TITLE COEN" OO ERNIENIAL
MOW TWO LW( 4O I TIIIHKIN USED MERTON. No TO TFE'AISSWNk1O1 OF THE
mg..Mir 1A41F8141.E 1n AoomoNAI Pisnrunolo TOWN 'OF SOUTHOLD — SUFFOLK COUNTY N.Y.
COPES OF INNS SURVEY WP NC lasso TIE NANO SURVEYOR'S NOM IVAL OR SCALE 1' = 30' DATE 9-4-2002
ENDORSED DEI.WILL NOT at CONSIDERED TO RE A Luo TRUE COPY. FILED MAP No. 54-48 DATE 4-9-1970
CERTIFIED ONLY TO: TAX MAP No. (REF ONLY) 1000-106-8-27 DISK 500
ZOUMAS CONTRACTING
SUNRISE ABSTRACT INC. HAROLD F. TRANCHON JR. P.C.
LAND SURVEYOR
Cr r77,./3.--,14.-- 1866 WADING RIVER—MANOR RD. WADING RIVER,
�+�'-`d� NEW YORK, 11792
. . LIC. No. 048992 831-929-4895
HAROLD F. T RA NC HON JR. PENN. LIC. No. 2115-E