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JUDITH T.TERRY ,� _ O$ Town Hall, 53095 Main Road
TOWN CLERK , y P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS ‘‘%1 471 Southold, New York 11971
MARRIAGE OFFICER �VS 490.0. Telephone
Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER �,( I 490.0. Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER 011
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1610 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : INLAND HOMES
Address 1 : P. O. BOX 117
City St Zip MATTITUCK NY 11952
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. SCHD REF. #R10-97-0010
Name Of Owner RAPTOPOULOS, KONSTANTI
Mailing Address 1 2026 55TH DRIVE
City St Zip MASPETH NY 11378
Property Address 1 WILLOW DRIVE
City St Zip EAST MARION NY 11939
Tax Map No. section 22.00 block 5 lot 17.000
Cross Street CEDAR DRIVE
Building Permit Number Cross Reference:
Issue Date: 3/20/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
•
•
OFFICE OF THE TOWN CLERK cLrf�(,�;,' •
f Southold
JudithTT`v Torry, Town Clerk �G�Or `,,- . Application No./( 6:3
Town Hall, 53095Main Road l. :it: - Construction t�
to t � -.t ••• j i
P. O. BOX 1179
Southold, New York 11971 • Alteration
Telephone / '°l . Jy fl1� :'zti1ntiai
•(516) 761301 " N
• TOWN OF SOUTHOLD •
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
•
APPLICATION
•
• for
CONSTRUCTION or ALTERATION PERMIT •
SEPTIC TANK or CESSPOOL
•
Permit No.
•
Fee .$ •
DATE 1/20/97
APPLICANT NAME: Inland Homes
APPLICANT ADDRESS: PO bOX 117iMattituck,NY 11952
SEPTIC CESSPOOL .
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
New single family dwelling
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Konstanti Raptopoulos
OWNER MAILING ADDRESS: 6626,55th drive,Maspeth,NY,11378
OWNER PROPERTY ADDRESS: Same jL.,c _e' ., 'fes•
TELEPHONE NUMBER OF CONTACT, PERSON: 298-9696
TAX MAP NO. : Section 22. Block 05 17 •
Lot
CROSS STREET: 400' north of cedar. drive,highpoint subdivision
BUILDING PERMIT NUMBER CROSS REFERENCE:.. pending• •
Signature of Appli •
RECEIVED BY: '
own erk's Office •
DATE: % - (7)- ( -1 )
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l am familiar with the STANDARDS FOR APPROVAL —.
AND CONSTRUCTION OF SUBSURFACE SEWAGE
N DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES
4c and will abide by the conditions set forth therein and on the
�-A ) permit to construct.
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66.36 , SURVEY OF
0- LOT 17
Q " OIINT AT EAST MARION SECTION ONE"
\3,,,,- Q 1 2�
s�n� ?r'�e� FLED JAN 1;1984 AS MAP NO 7590
29 _moo AT EAST MARION
TOWN OF SOUTHOLD
Zk. i50�, el, % 4 I SUFFOLK COUNTY, N Y.
LL. o Y j �, / ��• . ,0 - 22 - 05 - 17
o (°Q (012\ 6 s / HEALTH ',RV'i�;:,
P N - DaPAKrM�T of • Ca/e: 1" = 40'
P5,5 ,� r guFlot Appwrim,or� ,rR -� �a a. an. 7, 1997
�o
A(11) inat?*tZLE FABULY
te:rs ,t-� HS RSF .1► ,aif.* ONLY
) 47, 00 /
�e DATE - r+
V
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APPROVED i' -• -
S\ D'C R MUXIMUM OP BEDROOMS f ., 3
Q � FO
4 , / ce(' THBEE YEARS FROM DATE OF APPROVAL ' > `
0 1O
��1. / CERTIFIED TO, �p1
o f: A<(' ZORZIS RAP TOPOUL OS KONSTANTI L OS AA6P1(.44(tet°
S�'�p,E NAI°
zo4,-idt:z
AREA = 40,905 sq. ft. 0 2a �,�r s
�� �Q. �� ELEVATIONS ARE REFERENCED \ ,;�`'�� 4
ANY AL TERA TION OR ADDITION TO THIS SURVEY /SAVIOLATION Q, �VS� TO AN ASSUMED DATUM. �� .
OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW, �' h� / `t;��`�, J�,� ��
EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICATIONS tiro !` r .� LIC. NO. 49618
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY lF " 9 Adak4 e1ant.
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR c� ! The 1Oc01ions of wells and cesspools
PECONIC :2�»� P.C.
WHOSE SIGNATURE APPEARS HEREON. P
f5/61 765 - 5020
shown hereon ore from field observations P. O. BOX 909
ADDITIONALLY TO COMPLY WITH SAID LAW THE TERM ALTERED BY and or from data obtained from others. '
MUST BE USED BY ANY AND ALL SURVEYORS UTILIZING A COPY d 1230 TRAVELER STREET
OF ANOTHER SURVEYOR'S MAP. TERMS SUCH AS INSPECTED' AND SOUTHOLD, N.Y. 1197/
'BROUGHT-TO-DATE' ARE NOT IN COMPLIANCE WITH THE LAW.
96-301