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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK ® P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS 0 tl Fax (516) 765-1823
MARRIAGE OFFICER s/� ®,s� Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER O,� 4 i,i
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. 1145 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : GENE SOLOMON
Address 1 : 919 SHARI LANE
City St Zip EAST MEADOW NY 11554
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. SCHD REF. #R10-94-0037
Name Of Owner SPAHIDAKIS, DIMITRIOS & OTHERS
Mailing Address 1 36-17 24TH AVENUE
City St Zip ASTORIA NY 11103
Property Address 1 375 MADISON STREET
City St Zip GREENPORT NY 11944
Tax Map No. section 34.00 block 1 lot 1 .000
Cross Street MAIN STREET
Building Permit Number Cross Reference:
Issue Date: 6/06/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
0114),VF 01.k•to: _ 1 q. )
JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK
P.O. Box 1179
REGISTRAR OF VITAL STATISTICS , Southold, New York 11971
® l Fax (516) 765-1823
MARRIAGE OFFICER s'° �1� Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER =?�®,l Alf �l`
-FREEDOM OF INFORMATION OFFICER —:'", .Aakfi°!1�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD 1)
f
TO: Southold Town Building Department -IL fillgY 2 , '
FROM: Linda J. Cooper, Southold Town Clerk's Office /9 , , '
DATED: May 27, 1994 tO14VNCpG p /.•-'I
OFS Epi 6
11.4100 I
Transmitted herewith is a copy of application No. 1186 for a Cesspool/
Septic Tank Construction Permit submitted by:
Gene Solomon for Dimitrios Spahidakis and others_ •
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
DISAPPROVE
Comments: 5—, 7 �� //e — '3� d-a 3 7
7
RECEIVED / .�..
3`54.2 Pfr7 Signature
JUN- 31994 / f
Town Clerk South* Dated
_
'AO P
OFFICE OF THE TOWN CLERK cc\\VMi(CSG
Town of Southold "
y Application No. //f'
Judith T. Terry, Town Clerk E •
Town Hall, 53095 Main Road =3 ;74*. �`� ; Construction
P. 0. Box 1179 0.c. Alteration
Southold, New York 11971 _,0 •�0�-�
• Residential
Telephone _
(516) 765-1801 �" •Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT •
APPLICATION
for
CONSTRUCTIONor ALTERATION PERMIT
•
SEPTIC TANK or CESSPOOL '
Permit No.
Fee $
DATE . 12-7
APPLICANT NAME: 616-1\J� SOLO MOO
APPLICANT ADDRESS: 6{1 9 'S 4A 4 LAP . 1
/CESSPOOL ri Ai l,JorN Q15SEPTIC
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: ttPil\noS 6tAu DA IcI nJ11t,9A QM-041S) ioRdPDS yolzltytks
OWNER MAILING ADDRESS: 3(7-11 c 4 Mfa
(3t,'/' GLIA- SAS
As-6(l i1 I-Kr. riga
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: (�t(e) 4,1--0;461 , 110
TAX MAP NO. : Section Lt Block 01 Lot 0
CROSS STREET: IIMMJISb}J 4 l�'hit �� [ i.c .BUILDING PERMIT NUMBER CROSS REFERENCE:
4141 1 /
Signature of i .'.I ant
RECEIVED
RECEIVED B Y :
Town Clerk's Office
DATE: MAY 2 7 1994
Southold Town Clerk
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1
N CERTIFIED TO,
DEMETRIOS SPOHIDAKIS
EMILIA SPOHIDAKIS ��
er rq :5?" 25) IOAN/S KORNAS . '
W� , (NS• Rte.GLYRER/A KORNAS ,? • .
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SURVEY OF
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PROPER T Yw Zw pA AT GREENPORTM. w • oo
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"1 TOWN OF SOUTHOLD
TEST BORING SUFFOLK COUNTY, N Y.
CA - _ 1000-34-01-01&02
* 0 3 29 -0 O DARK BROWN Scale: 1"= 40'
N\ LOAM
Z 40, �D BROWN CLAYEY Mar. 22, 1994
AM
I• 2'
BROWN LOAMEY
. prg Q CLAYEY SAND -`
.c 31. M -3'
k O PALE BROWN
FINE TO COARS
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roP ` ""(',` Z SAND
1 I
P�r,� \ N O - 1 I
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r^ 6,, y /3.J' WATER W PALE bort E Fi-.6E.i DWE.LLNC ' ''v
V "` BROWN
ROWCOAR£FINE TO c RES THREE YEARS P Ote DATE OF APFRO1 1
D
—1 /7
rr ,
rn o eb g ,b1°°31 -- — " /Y + AREA =20,868 sq.ft.
o p.v /
j00o' K JR.'
R y
f W. ROS I, I am familiar w/lh the STANDARDS FOR APPROVAL tJ G
m?"'. T 6'`° S pO AND CONSTRUCTION OF SUBSURFACE SEWAGE 41-,:',,,.4-°;,9 ?,-
,5....a.
1 • S'. JOHN / DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES is o\
N/O/F 14 and will abide by the
t conditions
`sel forth therein and on the �+, _ y
`� VO'cc' / wet/ands p tU� 11NSPECTION REQUIRED N 'r3'
/_ 97fiNO reels O
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES OFN �P
ce will, the minimum FOR APPROVAL OF CONSTRUCTION ONLY
'eys as established •-- /jlf.-//1,1------
approved
A N.Y.S. LIC. NO. 49618
approved and adopted Hs.REF.NO. /0'q�• pa%7 /'
j l
Vew York Slate Land oar Y /ECONIC SURVEYORS, P.C.
gam (5161 765 - 5020
and cesspools ELEVATIONS ARE REFERENCED tl,� 2
� P. O. BOX 909
m held observations TO AN ASSUMED DATUM APPROVED • a MAIN ROAD
7inrd from others. ,-•,-.y, n,c /:y/9,I _-- _ - ____-- -S0117 HO(n, N.Y. /197/