HomeMy WebLinkAboutKougentakis, George ,
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z. CI rT1_ `s. tin Town Hall, 53095 Main Road
�`� P.O. Box 1179
'y�.jyol ��0�/ Southold, New York 11971
JUDITH T.TERRY '_ FAX(516)765-1823
%�..i,/,,,0 TELEPHONE(516)765-1801
TOWN CLERK
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 578 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : KOUGENTAKIS, GEORGE
Address 1 : 2171 EAST 34TH STREET
City St Zip BROOKLYN NY 11234
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 1/18/90.
Name Of Owner KOUGENTAKIS, GEORGE
Mailing Address 1 2171 EST 34TH STREET
City St Zip BROOKLYN NY 11234
Property Address 1 1725 WILLOW DRIVE
City St Zip EAST MARION NY 11939
Tax Map No. section 22.00 block 5 lot 7.000
Cross Street PINE TERRACE
Building Permit Number Cross Reference:
Issue Date: 2/01/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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., ' Town Hall, 53095 Main Road
Vi 'C '' '',Ac-.1 P.O. Box 1179
.-- Oj .. •�� �. Southold, New York 11971
JUDITH T.TERRY ".:010,0041,0�,r TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Victor Lessard, Southold Town Building Department
From: Linda Cooper, Southold Town Clerk's Office
Dated: January 25, 1990
•
Transmitted herewith is a copy of application No. 590 for a Cesspool/
Septic Tank Construction Permit submitted by:
George Kougentakis
•
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.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE X.
DISAPPROVE
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Signature
► Zi) 90
Dated
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OFFICE OF THE TOWN CLERK (JOFU1 * :
Town of Southold 40 C Application No. 576
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road . g Construction
P. O. Box 11790 *.$ Alteration
Southold, New York 11971 0":*.
Telephone _01 Residential
(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 $
DATE i - ZS , t) U
APPLICANT NAME: 6 €o iz G C` kc v G C N- T 4 l< I )
APPLICANT ADDRESS: 2,1 7 I (4 3 T 7 / ,s —T
8x00x,..y ,,- I• y x` 236/
SEPTIC )( CESSPOOL)c
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 6Efl1 GE Ko v CF'nrT/ k i
OWNER MAILING ADDRESS: 2 , 7 1 C!9 S 1 7c/ S T
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OWNER PROPERTY ADDRESS: ('l 2, C tiv j L. L.c „., o R 1 '.'t
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TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section 2 2.. Block 5 Lot -'
- CROSS STREET: e ,N r Egg /Tiv- L''F
BUILDING PERMIT NUMBER CROSS REFERENCE:
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i• ature of Applicant
RECEIVED BY: Ci(/.-----
own Clerk's Office
DATE: //.9-S//?O
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WIRES TWO YEARS FRD'<1 SATE OF RFRO'1AL
SURVEY FOR
GEORGE KOUGENTAKIS
• auFPOLK COUNTY D&PaxIMtNI OF htALIH SERVICF3 LOT N0.7,"HIGHPOINT AT EAST MARION,SECTION I" JAN.15,1990
AT EAST MARION DATE: JAN.4,1990
TOWN OF SOIITHOLDSCALE I"=5o'
FOR APPROVAL OF CONSTRUCTtOI O1VLY SUFFOLK COUNTY, NEW YORK NO. 89-1394
DATE HS REF. NO. NUNAUTNORIZED ALTERATION OR ADDITION TO TNIs \P(E OF NFW
SURVEY 4 A VIOLATION OF SECTION TZOS OF THE
A NEW YORK STATE EDUCATION LAW S D EY A-
NEW
*COPIES OF THIS SURVEY NOT GEARING THE LAND •#P"-
APPROVED SURVEYOR'S 'NEED SEAL OR ENGORGED SEAL SHALL O T.0 f
NOT BE CONSIDERED TO GE A VALID TRUE COPY * t Z
INDICATED HEREON SHALL RUN ONLY TO
THE PERSON FOR WHOM THE SURVEY IS PREPARED 1 0
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT i
ANO ON HIS BEHALF TO THE TITLE COMPANY,GOVERN- A.
* Wm* MAIN MI • *SOURCE OF WATER.MATE_PUGIIC_ MENTAL AGENCY AND LENDING INSTITUTION LISTED i
G YAP CO.TAR MAP DELT 1000 SECTION BLOCK....1....LOT HEREON,AND TO THE ASSIGNEES OF THE LENDING
*THEW ARE MD DWELLNMS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION GUARANTEES ARE NOT TRANSFERABLE
OTHER THAN THOSE SHOWN HEREON TO ADDITIONAL INSTITUTIONS OR SUGSEOUEMT O.4589'
N THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM POR THIS RESIDENCE OWNERS
WILL CONFORM TO THE fTAMOIM
AROS OF THE SUFFOLK COUNTY A DISTANCES SHOWN HEREON FROM PROPERTY LINER .f`. 1•
OF HEALTH SE VVICES. TO fK)STING STRUCTURES ARE FOR A SPECIFIC LAM X
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PURPOSE ANO ARE NOT TO SE USED TO ESTABLISH
APPLICANT PROPERTY LINES OR FOR THE ERECTION OF PEACES
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ADDRESS
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T[L 0Iq)351-15-I+{ YOUNG a YOUNG w YORK
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NOTE, ■.MONUMENT •.RE-BAR W/CAP 'S
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF ALDEN W.YOUNG,PROFESSIONAL ENGINEER kr
SUFFOLK COUNTY ON JAN.11,1984 AS FILE NO.7680. AND LAND SURVEYOR N Y.S.UCENSE NO.12845 /41 Amo
N HOWARD W.YOUNG, LAND SURVEYOR yV'? (\
AMC LOCATION a WBLLIWI,SEPTIC TANRIST)Sccssroastcrl warm N.Y.S.LICENSE NO.45893 4IrC J
41.ARL PROD/MD OMBENRMTIONS MIO OR DATA OBTAIN/Draw OTHERS 97
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BRAND'S L SONS INC.
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