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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK ® T • P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS '�` Fax (516) 765-1823
MARRIAGE OFFICER
- � Telephone (516) 765-1801
al„ 116
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 693 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : EDWARD FAIVRE
Address 1 : P. O. BOX 229
City St Zip MILLER PLACE NY 11764
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLIN WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 12/19/90.
Name Of Owner PANAGOPOULOS, KONSTANTIN
Mailing Address 1 PANAGOPOULOS, PEGGY
444 EAST 82ND STREET
City St Zip NEW YORK NY 0000
Property Address 1 920 THE GREENWAY
City St Zip EAST MARION NY 11939
Tax Map No. section 30.00 block 2 lot 37.000
Cross Street THE STRAND
Building Permit Number Cross Reference:
Issue Date: 3/20/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
FFEB 1991 : 1 i ir:
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C�VeN OF ti. :+ Ct• r' = 53095 Main Road
._ J r ;;:, .' P.O. Box 1179
-'I�/ : Southold, New York 11971
JUDITH T.TERRY l- TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Southold Town Code Enforcement Officer
From: Linda Cooper, Southold Town Clerk's Office
Dated: February 27, 1991
Transmitted herewith is a copy of application No. 706 for a Cesspool/
Septic Tank Construction Permit submitted by:
Edward Firvre for Konstantin and Peqqy Panaqopoulos .
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 bC
DISAPPROVE .
Comments:
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Signatur-
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Dated
OFE,ICE SOF THE TOWN CLERK
Town of Southold � ; �: BOG
Judith T. Terry, Town Clerk ;` =., Application No. �d
Town Hall, 53095 Main Road o � _ '
.,}, `� jam '` Construction t-
P. 0. Box 1179 ;,;, : -
Southold, New York 11971 0• Alteration
& .
Telephone 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 $ /0
DATE Y' 42-v1 Va-?) 199)
APPLICANT NAME: wq fATI/Q.y
APPLICANT ADDRESS: Po eox 9
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Lex prcE 1",/
Y i I-7
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
S/(:/g26 iLY ‘4SE-
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: HoN5f-t-NTlrv ,t PeCGy i)79Nfi6_vioOuLOS
OWNER MAILING ADDRESS: 1Y 99 .CP-ST Sc)- S7
OWNER PROPERTY ADDRESS: 9. 0
TELEPHONE NUMBER OF CONTACT PERSON: 331 -7,65S—
TAX MAP NO. : Section 030 Block Lot 3 7
CROSS STREET: 7 � rD
BUILDING PERMIT NUMBER CROSS REFERENCE:_
q
Signature of Applicant
RECEIVED BY: V_Ze1
Town' Cle° is, 6 �fce
DATE: ,!) -
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• SURVEY FOR
KONSTANTIN PANAGOPOULOS a PEGGY PANAGOPOULOS
bUFFOLK COUNTY DEPARTMENT. OF HEAtTH SERVICES LOT 100,"MAP OF PEBBLE BEACH FARMS” NOV 29,199 0
AT EAST MARION DATE• AUG 6 0990
FOR APPROVAL OF CONSTRUCTION ONLYTOWN OF SOUTHOLD SCALE• I'"= 4d
i'_
DEC 191990 ' .--s p / SUFFOLK COUNTY, NEW YORK NO. 90-0573
DATE HS REF. NO. N UNAUTHORIZED ALTERATION OR ADDITION TO THIS
GUARANTEED TO:
v ---w— SURVEY N A VIOLATION OF SECTION 7209 OF THE KONSTANTI• KAfC^"• OS
— - ` NEW TORK STAT[CDUCATION LAW
�� N COPIES OF THIS SURVEY NOT SEARING THE LAND PEGGY P .6, • •
EPPROVED I, SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL TRW TI IAA. ,.,••NY OF NY.
30 /_ .0,S(J--p2 S 1 NOT BE CONSIDERED TO BE A VALID TRUE COPY O,�' L O • S 65321
(J IN GUARANTEES INDICATED HEREON SHALL RUM ONLY 1D
HEALTH DEPARTMENT-DATA FOR A-"- TO C'' TRUCT TME PERSON FOR WHOM THE SURVEY IS PREPARED 4. 4" 1 0
AND ON NIS BEHALF TO THE TITLE COMPANY,GOVERN- _• 0
N NEAREST WATER •AIN MI • N SOURCE OF WATER.MATE—cPUSLICL MENTAL AGENCY AND LENDING INSTITUTION LISTED 'CT:if'M SUFI CO TAX MAP DISTT000 SECTION. Q...BLOCK 3_LOT yL HEREON,AND TO THE ASSIGNEES OF THE LENDING
N THERE ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION GUARANTEES ARE NOT TRANSFERABLE ��
OTHER THAN THOSE SHOWN HEREON TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT •••
N THE SUPPLY AND SEWAGE DISPOSAL FOR THIS RESIDENCE ,O,DIST NCE! SHOWN HEREON FROM PROPERTY UNE! + ) ! a .0 89 , i/ • ,
WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT TO EXISTING STRUCTURES ARE FOR A SPECIFIC fy
OF HEALTH SERVICES PURPOSE AND ARE NOT TO BE USED TO ESTABLISH 4 "O.AN*LICANT'/ii \ rArv2E PROPERTY LINES OR FOR THE ERECTION OF FENCES 44ND SUS
ADDRESS ,�0, IqQ K ; D-7 /� '
fY Le-x / c NY 117b71 331-_133 YOUNG a YOUNG 400 DER
RtVERHEADNNEW YORKE
o•CONCRETE MONUMENT O.PIPE st
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ALDEN W.YOUNG,PROFESSIONAL ENGINEER
ON JUNE II,1$75 AS FILE NO.SSSS AND LAND SURVEYOR N Y-S LICENSE NO 12845
HOWARD W YOUNG, LAND SURVEYOR I
K THE LOCATI011 OF WELL(WI,SEPTIC TAMK(STIS CESSPOOLS(CP)SHOWN HEREON N Y S LICENSE-NO 45893
ARE PROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHER S
IDY POST FO.o.