HomeMy WebLinkAboutGiannaris, John t
OFFICE OF THE TOWN CLERK c,IFOU0,,
Town of Southold Off.
Judith T. Terry, Town Clerk , # t.
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 11971 O O�
Telephone
:WO 41 ��
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 150 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool X
PERMIT ISSUED TO:
NAME: John and Anna Giannaris
ADDRESS: 5145 Main Road
East Marion, New York 11939
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Single Family Dwelling
APPROVED as per Suffolk County Department of Health Services approval.
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: John and Anna Giannaris
OWNER MAILING ADDRESS: 5145 Main Road
East Marion, New York 11939
OWNER PROPERTY ADDRESS : Maple Lane
East Marion, New YOrk
TAX MAP NO. : Section 35 Block 5 Lot p/o 5
CROSS STREET: Main Road
BUILDING PERMIT NUMBER CROSS REFERENCE:
0161r •
4444er..../.
Judith T. Terr
Southold Town Clerk
DATE: April 21 ,1987
(TOWN SEAL)
r
t d r//....
!
T 4 y435
Town Hall, 53095 Main Road
6N' °'� P.O. Box 728
- 4 ,,, Southold, New York 11971
JUDITH T.TERRY TELEPHONE
TOWN CLFRK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
April 15, 1987
To: Victor Lessard, Southold Town Building Department
From: Judith T. Terry, Southold Town Clerk
Transmitted herewith is a copy of application No. 154 for a
CONSTRUCTION or ALTERATION Permit for a cesspool or septic system
submitted by John and Anna Giannaris •
Please review the application and location map and advise if the
project has received Suffolk County Health Department approval
and if we may issue the permit.
Please complete the form below and return it to my office.
Thank you.
egil4W41...1"41.1
Judith T. Terry
Southold Town Clerk
* * * * * * * * *
I have reviewed the application and location map of the project
cited above and make the following recommendation:
APPROVE -
DISAPPROVE - \
COMMENTS: c 'I-\ Q. , ,SLcti - U.&c.4-4
Signature
Date
,OFFICE OF THE TOWN CLERK
Town of Southold
No.-'l.S-'
Judith T. Terry, Town Clerk Application
Town Hall, 53095 Main Road Construction
P. 0. Box 1179
Southold, New York 11971 Alteration
Telephone Residential 1
(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 .$ /b
DATE op-, / (7 g7 -
APPLICANT NAME: o --- C__- JLI 7-1 G / AV S
APPLICANT ADDRESS: 57 v /on I )-( 12
I-5 4- s- m A )2(°"( r t 93
SEPTIC4CESSPOOL✓;3
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION / (A)
&t i S ET
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY:I-Okit& 2.4 poq Cii9 pJy/9
OWNER MAILING ADDRESS: s-f 7 s pf/i-f R
OWNER PROPERTY ADDRESS: mo P LE L-4 Hr 73 Lodi
r 9 / 'rY)
TELEPHONE NUMBER OF COC CT PERSON: 770/ 3 3
TAX MAP NO. : Section Law Block .1y S- Lot p/,,
.�!
CROSS STREET: fnick/ T( /a:9
BUILDING PERMIT NUMBER CROSS REFERENCE:
/ 17' Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
. . .
__.__
_ ,
—_ _ _________
• . V-- ----.7"—s. .
APPROVAL
. . .
. . •
. .
. . .
. . . . .
i .'
OCT 28 1986
St DV i
___. _ HEAtili 1,*v fIX-S• _
, ...,.
./ • STA rEMENT OF INTENT
_
il t THE WATER SUPPLY AND SEWAGE DISPOSAL
SYSTEMS FOR THIS RESIDENCE WILL
CONFORM TO THE STANDARDS OF THE
– .
SUFFOLK C. EPT.EPT. 0 HEALTH SERVICES.
1
SINGLE F MILYA, :;.'
. ,
, ,
\ . „EXPIRES TWO Y RS FRO i ' _ OF APPROVAL
., \ . - - 4,• /./t /z.i "),/,,,/,A /z _\ SUFFOLK COUNTY DEPT OF HEALTH
, \ .
,
,s1
\ • _ – - SERVICES FOR APPROVAL OF
CONSTRUCTION ONLY
lit (E ?
, DATE. .
1..‘ rIStK
_ •-.....
, .
/ APPROVED. I
f 'II\
I / '
Ill? co
J ;
SUFFOLK CO. TAX MAP DESIGNATION:
, DIST. SECT BLOCK PCL.
...) ,
i
. ,
........ - OWNERS ADDRESS.
, .
'3 •
\ . sC;'15C))c 108
tv East lict,ri\aY) 3?
NI
,• 4 5' 1 ‘.
_____ ,
•
• DEED. L. P
: • s
TEST HOLE STAMP
...,... , ,...„...„
. „ ,.:...r...,....,,,,%,„.., •
........ ,„.„,...„.„.,,
„. .
, .•
, •
' • '. , • ..,•:,)r:ic:;/7.1•••,)
. . , • )),.No:••••.,:.--p--;
,
‘ , • , ,-*; d
.. : ;:-..”:
::'. ,- ::
-.':f, (71,.) , • ' *.•••--)-..r..y r.-.:1
, ' . • •‘;'11-f•:,;L-,.••,:5.
, ..) ;•- ;)•-...•.tur:.,3•:,,)•.
. .
, . .
. .
, . — - ' 'I e. .. • ; ! .:.' •)7/ -.2:',';:/ I'1-:. " - .1.)-,• -r r:oh;A:,:z;ktnt
, .
• ' . .
• / . :72cr:,,,71i .,,' SEAL
„,, .
•
• '
, ,..,., 2 . . ' •, • . of N Eit,
, .
,
.
. , _
• , P
• •Cfc. cy. VA 0
• • ' kr oN 4, -P
. .
10.1 1c. - • ,).. f•
1 (')01) Cf. ,I,- 6,4 • s
•
, .
RODERICK VAN TUYL, P.C.
(
• . i.
0 ch /v., • • (e)
. , , -e , ,/,:/ . --, •• ' 'f /i/. il re,' -/ - ' . _
' 1 • LS 2 `" IF
, r Se.°LAND
•
LICENSED LAND SURVEYORS,, "
• GREENPORT NEW YORK
. —
----
. ...
•
•
, .