HomeMy WebLinkAboutVouvoudakis, Demetrios G �
JUDITH T.TERRY ��_ 'yam Town Hall, 53095 Main Road
TOWN CLERK ` y i P.O. Box 1179
v. n? ,t Southold, New York 11971
REGISTRAR OF VITAL STATISTICS `0 1 Fax(516) 765-1823
MARRIAGE OFFICER p yijJ 0��I
RECORDS MANAGEMENT OFFICER Ol 41(
Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER ,'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1654 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : THEODORE C. MARTZ JR.
Address 1 : 145 RYERSON AVENUE
City St Zip MANORVILLE NY 11949
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. #R10-97-0002
Name Of Owner VOUVOUDAKIS, DEMETRIOS & WIFE
Mailing Address 1 146-06 24TH STREET
City St Zip FLUSHING NY 11354
Property Address 1 635 STANLEY ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 106.00 block 8 lot 14.000
Cross Street LUTHERS ROAD
Building Permit Number Cross Reference:
Issue Date: 14/30/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
-_.\\FFULK `h I
: APR 2 8 1997
i Town Hall, 53095 Main Road
Ill i }- P.O. Box 1179
4,,1` ,'` 1 .Southold, New York 11971
JUDITH T.TERRY ',. TELEPHONE
TOWN CLERK •' (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: April 28, 1997
Transmitted herewith is a copy of application No. 1736 for a Cesspool/
Septic Tank Construction Permit submitted by:
Theodore C. Martz Jr. •
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.
Thank you.
4,7x°1
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE
Comments:
RECEIVED
Sign
7
APR 2 9 1997 � �y7
5 3G Dated
za bold Tow i CI tit
OFFICE OF THE TOWN CLERK 0c3\!
FFOLA- Z
Town of
Judith T. Terry, TowSouthold n Clerk ' Application No. /7
Town Hall, 53095 Main Road o y� 44/..: Construction /-----
P.
---'P. 0. Box 1179 ,Y: �'
Southold, New York 11971 O Alteration
��'. Residential z------
Telephone �l ��
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
'APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee •$ -{
I
A
APPLICANT NAME: , I /r
� 21).8 4
,JR .
APPLICANT ADDRESS: I g t-Rs4-44
4 +%ilLti ilglci
SEPTIC CESSPOOL
DESCRIPTION 0 SED CONSTRU ON 0 ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issue/d.
• LOCATION OF PROPOSED CO TRUCTION OR A • TION: V00pfll(/S
OWNER OF PROPERTY: dei g10E 4- 4 el` \1040.141<i6
OWNER MAILING ADDRESS: I TOO t• !ll i
14,Q11 11 i )40.4) ,e. 114.....
•
OWNER PROPERTY ADDRESS: 10 IM Li + - 41
itliu*i )44 iiqC-2_.
TELEPHONE NUMBER OF CONTACT ERSON: -Intt, '--818-_ EM$
TAX MAP NO. : Sect /01j `.lock b$ Lot `
i
CROSS STREET : ; 4 ' 4/(6)-43
BUILDING PERMIT NUMBER CROSS REFERENCE:
/ /
Signature ofA•,plica
RECEIVED BY: ! " / -ic_ •�
Town Clerk's Office
DATE: `6 F5` ,// c----
'
/
n1
l am Familiar with the STANDARDS FOR APPROVAL
''''e, %o s .pubis, „,o..,. AND CONSTRUCTION OF SUBSURFACE SEWAGE 1
DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES
5,.e Si and will abide by the conditions set Forth therein and on the
permit to construct.
STANLEY . 55
ROAD
bhc w,,seer in st.
5,., S. 87%1'00'E WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS MUST
—� � 105.00'
°w, ».e. 545' CONFORM WITH NEW STANDARDS DATED NOVEMBER 13,1995.
i tl j
Cr) V , r•v r.eL, O
�'� `Y'� a (4' SURVEY OF
°r LOT 12
SUNSET KNOLLS
r,-tea=+� 25. NO.5023
� � �A JANMATT 1968 TUCK
N
. Jay C. TOWN OF SOUTHOLD
h SUFFOLK COUNTY, NY. -„,c :.
1000- 106-08- 14 E.`
\!' Scale: 1”= 30'
a v Sept. 23, 1996 . ° -
Dec. 27, 1996
3
t
-J'=J:.1.COUY?Y DEPART MIT OF PE.A.LTH SERVICES
PERMIT FOR APPROVAL CF CiNL":•F.UOi:FOR A
4i INCILE EAP U r.::s_ rENC ONLY
oo o .,Am /�yk14— ^F. 'O.,' _ `7-�-- c�
0
a) APPROVED
..
LOT 11 P en
LOT Q FOR MAXIM1JNf OF V BEDROOMS
ON ® • LOT 13
o N O
o EXPIRES THREE YEARS FROM DATE OF APPROVAL
Y US
Man NEW
--
4.1M. ,,,:c.,\ 1.ME r�9'F- .
- _ C
• -- • --• •------. ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLA 770N
�' �o� Y F4
°$ s- N 88'47'00' W /05.04"+' 5 • OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW, ..-,-..V?'"
m,
EXCEPT AS PER SECTION 7209-SUBDIVISION 2.ALL CERTF7CA TIONS ��\\\ b
a e HEREON ARE VALE YOR THIS MAP AND COPES THEREOF ONLY F ���V{I j 1 .-;
Formerly KLEINSCI' NDT SAE MAP OR COPES BEAR THE IMPRESSED SEAL Or THE SURVEYOR AsA,•� ,.� -� .r
WHOSE SIGNATURE APPEARS FIERfON C`,'.',» \,1 �+' .�C
ADDITIONALLY TO COM°LY WITH SAE LAW THE TERM 'ALTERED Br VV�g� .,.n1 , ' w 1,4•'�-a�-
MUST BE USED BY AM'AND ALL SURVEYORS UTILIZING A COPY 17�'
The locations of wells and cesspOoIs OF ANOTHER SURVEYORS MAP. TERMS SUCH AS'INSPECTED'AND , CON/r7Y''T7T"P.C.
shown hereon are From field observations
WROUGHT-TO-DATE'ARE NOT w COM .MANCE WITH THE LAW. a d++ (5161 765 - ;--"'="
P. 0. BOX 909
and or From data obtained from others. dyCA 1230 TRAVELER STREET
ELEVATIONS ARE REFERENCED AREA =20,330 SQ. FT. SOUTHOLD, N.Y. 11971
TO AN ASSWED DATUAL
96 - 272