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HomeMy WebLinkAboutKoutsouras z 11) ®� a 942 JUDITH T.TERRY 1 � �A-f R �. Town Hall,53095 Main Road TOWN CLERK :g4 r` x;, u P.O.Box 1179 REGISTRAR OF VITAL STATISTICS - °&, �/� Southold,New York 11971 Fax(516)765-1823 MARRIAGE OFFICER ��11 RECORDS MANAGEMENT OFFICER ®11 ErL73 ��„11 Telephone(516)765-1800 FREEDOM OF INFORMATION OFFICER ..co OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 3422-R Residential X Non-Residential Fee $ 10.00 New Existing X Name Of Owner KOUTSOURAS, MICHAEL Mailing Address 1 P. O. BOX 800 Mailing Address 2 City St Zip MATTITUCK NY 11952-0000 Property Address 1 200 SUNSET DRIVE Property Address 2 City St Zip MATTITUCK NY 11952-0000 Owner Telephone No. 516-298-5013 Tax Map No. section 106.00 block 7 lot 45.000 Cross Street STANLEY ROAD Issue Date: 12/15/95 Judith T. Terry Southold Town Clerk (TOWN SEAL) OFFICE OF THE TOWN CLERK .CSMit Town of Southold �� CQG=� Application No. 3 Judith T. Terry, Town Clerk Town Hall, 53095 Main Road • -� $10.00 - Residential P. O. Box 1179 ��`� $25.00 - Non-Residential Southold, New York 11971 O *�` Telephone 0j * 0?-./ (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT { APPLICATION E for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ 10 DATE i4)3145- OWNER c ll3 qsOWNER NAME: /1//Ch OWNER MAILING ADDRESS: •j `T a' r'.,,67O fta, 09 a 1-17 -h c/c - -- - OWNER -PROPERTY ADDRESS: ---C6c-,9 .def ,4,4,-/ve- inQ i f� cIc rCq OWNER TELEPHONE NUMBER: C5i 'a) Q9 - $o/3 TAX MAP NO. : Section /0(0 -7-Block Lot CROSS STREET: �./25.c. / P/)✓e $t /e y /e0 4 { TYPE OF SYSTEM:-: Septic' Tank' •' New Existing Cesspool ✓ New Existing • Residential V 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.) �co� Signat re of Applicant RECEIVED DEC ; .rl1 RECEIVED BY: - Ov Stas )i., • Office DATE: ... I TITLE NO 76-52-07406 • . '. 11\\( . _ ki ., • . . . , • • ..„...... • Ev66. ,. z , . 8 • . u- Los ,, - 56 , . ,,,, , \ e_. • . . „.) . .e. • \ . o • , Z nN . ' • , , FF >n � 3O • F W �031 • _ o \ , -. \ • + 61 � • r; ,. \ c ch 1.--).\,. --" \ .1 . \*. • • EL_72.9 • \ C� •-e, .. , N co ct}- O x '23, O • o �� O i s3� A 4 - -, tv N \ \,'�� ,► -el \E06 2„8,9••Ga - t w0 • �1 CJ1 \,�� `�N9 wafer er ce� ' \ . �CO n to • l-- \O, \ t - -.. `i\ % - t • � S 6103 c'� •' ' ...,_.: ......................„..- ko , , . \ . . . , ;:: PZE OF NEiv • . S� r , �p tD W, Y O�PI v'. •• , . O pG it tiG " ROA e¢ 45S9 ,• , E LY • • , • 4f, LAND WO- i (�� /TAI ` • • •REVISED: .6 - . ' , 1 : '-VI .- .L7: `-x-72, • JNAUTHORIZED ALTERATION OR ADD'TION TO THIS SURVEY IS A VIOLATION OF ' NOTES ©T MONUMENT LI:STAKE 1 SECT ON 7209 OF THE NEW YORK STATE EDUCATION LAW - COPIES OF THIS SUBDIVISIa1 MAP FILED IN THE OFFICE OF THE CLERK OF SURVEY MAP NOT BEARING THE LAND SURVEYORS INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A vALID TRUE COPY - GUARANTEESSUFFOLK COUNTY ON APR.9, 1970 AS FILE N0.544 . • THE s., vET IS I PREPARED,AND ONNHIIS BEHALF ON ,-1EOTTTI,r COMPANY, GO HE PERSN FOR ERNVENTALHAGENCY WATER SUPPLY-PRIVATE WATER COMPANY • AND LENDING INSTITUTION LISTED HEREbN, AND TO THE ASSIGNEES OF THE 1 LENDING INSTITUTION GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL iii ` --Y— - INSTITJTIONS OR SUBSEQUENT OWNERS ROYAL 'THE LOCATION OF WEI;S AND CESSPOOLS SHOWN HEPFON AE FROM FIEL D URVEY FOR GUARANTEED''TOOBSEQVATlONS AND/OR FROM DATA OBTAINED FROM OTHERS ' 'I USLIFE TITLE INSURANCE — — FERN, INC. COMPANY OF NEW YORK T$E WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCF WILL - �QU'('NOLD SAVINGS FLANK. I CONFONM.�0 THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT Or 'IF AL'H SERVES - LOT ,•{F �,I.IcAN r . :_. 111 SUNSET KNOLLS, ' �, ;I;;r�tss= -- - - - rE� __- - -- SECTION TWOIF • • ' ryt�/ AT yMATTITUCK TOWN OF ' . ALDEN W YOUNG, P FESSI ON?lL SOUTHOLD ENN YGS EEC NOD12845 SURVEYOR SUFFOLK COUNTY, N Y. N Y SRCC NO z,e9L3NC SURVEYOR _ • ' •• YOUNG a YOUNG, LAND SURVEYORS ' ' : , 400 OSTRANDER AVENUE • I ��° RIVERHEAD, NEW YORK DATE-- , SCALE, NO.; f l („: 76-194 /��, �, c /1 •��� � MAR.31. 1976 4b