HomeMy WebLinkAboutGianukakis, Ida . O �p
ELIZABETH A. NEVILLE ���_ yd Town Hall, 53095 Main Road
TOWN CLERK ; co •
� Southold, New York 11971
Z P.O.Box 1179
REGISTRAR OF VITAL STATISTICS �ARRIAGE OFFICER 4, ����� Fax(631) 765-6145
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RECORDS MANAGEMENT OFFICER =_'�1O 47- Telephone (631) 765-1800
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FREEDOM OF INFORMATION OFFICER - ��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4026-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner GIANUKAKIS, IDA
Mailing Address 1 80 PERRY AVENUE
Mailing Address 2
City St Zip PORT CHESTER NY 10573-0000
Property Address 1 5280 THE LONG WAY
Property Address 2
City St Zip EAST MARION NY 11939-0000
Owner Telephone No. 914-937-5033
Tax Map No. section 21 .00 block 5 lot 16.000
Cross Street THE LONG WAY
Issue Date: 5/16/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK COMee,"
TOWN OF SOUTHOLD , st $ G Application No.
70 26
ELIZABETH A.NEVII.I.F,TOWN CLERK ,. l $10.00 - Residential C�
P.O.BOX 1179
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SOUTHOLD,NEW YORK 11971 ��� $25.00 - Non-Residential
106
Telephone �� "
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL 'DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. «
osa
Fee $ /0.00
DATE �/6 0O
/ .D Q44 /S
OWNER NAME: '�
OWNER MAILING ADDRESS:
72,40ea4entz
Q
wee, mil /06-j
OWNER PROPERTY ADDRESS: 0 od,
,off, 'V //18
OWNER TELEPHONE NUMBER: /)54-" " so-
TAX
TAX MAP NO. : Section c3W' Block Lot /6`63e°
CROSS STREET: leeC1
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool x New Existing
Residential Non-Residential
LOCATION MAP: Must be attached hereto before permit may be issued.
(Locate building and system; give north arrow and feet
of distance, approximately, to building and closest road.)
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Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
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SURVEY OF PROPERTY
AT EAST MARION
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
1000-21-05-16
X
SCALE: 1
APRIL 5, 1999 1999
NOV.17,1999(conc.foundations 1
FEB.2,2000(final 1
SUFFOLK MINTY DEPARTMEMOF FTEALTH SERRVICF3
AP fi S...I'r 5 T "'=_
C1 WO FOR
vor • FEB 2 5 26dQ '.- .es),2;cc
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® ® The Iocotion oil wells and cessaods
(VA-ANT shown hereon a from field Maur wtiens
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and or data oatoined from others
e IAPPRam OVAL/V7L'ANO withCONSTthe RSTANDARDSUCTIONOF SUBSFOR
URMACF
tDWELLtS*Gj.TCR SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY
PVOLIC V, RESIDENCES and*11 Malde by tae conditions Set
03 lain therein And on the Permit to conslract.
ELEVATIONS REFERENCED 10 AN ASSUMED DATUM
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1.
0.6'
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j' w Lot numbers refer to'Peelle 9socn Form.
' 18.21,-"' VI° fled In the Suffolk`County Oerk'S Office
OrEli.� N on June 11,1975 es F e No.6266.
IVACANt)
AREA = 21,180 sq. OF NE*fr
"osoT.tfe)le 0'
,7
3 /,1..a....0 s s NO 49618
ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION PECO SUR 1„�..,Y..I.i•. P.'"-
Of SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW w
EXCEPT AS PER SECTION 7209-SUB0IV7SION 2 ALL CERTIFICATIONS (63/) - "" AX.- 1 765-1797
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF P. 0 :•....J9$4 AN „. (](�]]—/ /./IyO
• SAID MAP OR COPIES REAR THE IMPRESSED SEAL OF THE SURVEYOR 1230T SOUTHOLD. N ;1 1 I Jaz
*NOSE SIGNATURE APPEARS HEREON •