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ELIZABETH A.NEVILLE `s�_0 ®'� ; Town Hall, 53095 Main Road
TOWN CLERK % d P.O. Box 1179
REGISTRAR OF VITAL STATISTICS i Southold, New York 11971
MARRIAGE OFFICERFax(631) 765-6145
RECORDS MANAGEMENT OFFICER ‘44?
Ql 4;00 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ,s" southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2891 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : T. VOUMVOURAKIS
Address 1 : 8408 7TH AVENUE
City St Zip BROOKLYN NY 11228
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-02-0124
Name Of Owner VOUMVOURAKIS, T.
Mailing Address 1 8408 7TH AVENUE
City St Zip BROOKLYN NY 11228
Property Address 1 400 WILLOW DRIVE
City St Zip EAST MARION NY 11939
Tax Map No. section 22.00 block 5 lot 30.000
Cross Street CEDAR DRIVE SOUTH
Building Permit Number Cross Reference:
Issue Date: 9/24/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE it�_� �0 : Town Hall, 53095 Main Road
1
TOWN CLERK % 2 1 P.O. Box 1179
,y. Southold, New York 11971
REGISTRAR OF VITAL STATISTICS • ft 0 Fax(631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER ' �Ql 40 441A-r% I Telephone (631) 765-1800
FREEDOM OF INFORMA�fo 1 F,FICER rr c southoldtown.northfork.net
\ ' t ® 3 202 ;ate \k OFFICE OF THE TOWN CLERK
1�, S�Q r+ TOWN OF SOUTHOLD
TO,: ,;;,1Soiithol"ii Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: September 3, 2002
Transmitted herewith is a copy of application No. 3001 for a Cesspool/Septic Tank
CONSTRUCTION/ALTERATION Permit submitted by:
T. Voumvourakis
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.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE _
Comments: Maintain required setbacks from adjacent wells,buildings,property lines and water
Bodies. EXCAVATION INSPECTION REQUIRED. ��
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Signature
e)19/4: 7/;,2—
Dated
OFFICE OF THE TOWN CLERK �,',,'•"„",•,�'��_
TOWN OF SOUTHOLD c�uFFock� _
Ri77ABETHA.NEWT.T.F,TOWN CLERK �', O oay Application No.��f
P.O.BOX 1179 (--/Construction
1
SOUTHOLD,NEW YORK 11971 : _ 'Z _
ct� Alteration
Telephone _• � $10.00 - Residential
(631) 765-1800 - �l i ,' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$ 9/ o1oz•
DATE
APPLICANT NAME: .i7e01101 t" Ak [Cr S
APPLICANT ADDRESS: qtfog ,41
6gookui ),‘ ti 2.2
SEPTIC J CESSPOOL C.i
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: "_, rt�t,�, k1 S
OWNER MAILING ADDRESS: j(/Qy `� �e
3p/,Lt7 pi L1 1122 k'
OWNER PROPERTY ADDRESS: t figo ,f L.Lew biiacs '
�S-f 0444100
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section Block c Lot 3D
CROSS STREET: Cel) b/tsv-e SO041,
BUILDING PERMIT NUMBER CROSS REFERENCE:
ti
Signature of • pplicant
RECEIVED BY: •
Town Clerk's Office
DATE:
S.C.T.M. NO. DISTRICT: 1000 SECTION: 22 BLOCOK: 5 LOT(S):31 `
WELL J°'
ELEV. 48.9 VACANT
TOPSOIL11.0 \
LOAM �� MON.
3.0 �P�\O� , 0/L0.5w ' MON.
3.4'S _
SAND DWELLING �PG'� G��J�1 EL 48.6
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''��G� LAND USED BY OTHERS cp'' T+
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NO WATER 1�' 0 0(3 \
QQSUFFOLK OUN DEPARTM OF HBAL.TH ' 'VICES
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04-06-02 Gv \ 2
MON. PERMIT OWObi 'U�"Y';[ON FOR A i
AT LOT 30
CORNER \/ ,g O•L. �.AL Y®F w OY
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/v \-) FOR 1\ XIM op ��ROOMS
CO Ute" +'OM DATE OF APPROVAL
N. PROPOSED WE. 1 EXPIRES THREE YEARS
DWELLING LOCATIO M•t ,��
LOT 292 ..> .
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\ VACANT
WELL° 0 I
20'/ .\--3-•' O.
CESSPOOL OVER 100I I 6G O'
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CL 50.27 WILLOW 28 Tc 4838
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TC 49.64 '�\�P��
\\ / DWELLING
DWELLING �O / REVISED SANITARY 6-6-02
W UNDER CONSTRUCTION \ THE WATER SUPPLY, WELLS AND CESSPOOL
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LOCATIONS SHOWN ARE FROM FIELD OBSERVATIONS
AND OR DATA OBTAINED FROM OTHERS
AREA: 42,326.70 sq.ft. or 0.97 Acres- ELEVATION DATUM: Assumed
UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY
MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION
LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE.
THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE'FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE
NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES, ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMENTS
AND/OR SUBSURFACE STRUe-TURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY
SURVEY OF. LOT 30I� CERTIFIED TO: GEORGE VOUMVOURAKIS;
MAP OF: HIGHPOINT AT E• j `t ° SECTION TWO
'3V,Iii 30
FILED: JULY 13, 1984 O, 775'S '_44 ./0,k o
SITUATED AT: EAST MARION •QI��ii �f r
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TOWN OF: SOUTHOLD ' t %^/i ) ¢,w,6 I KENNETH M. WOYCHUK L.S.
SUFFOLK COUNTY, NEW Yf���c�-1, °�,.--, -,i � Land Surveying and Design
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P.O. Box 3, Mattituck, New York, 11952
_ PHONE (631) 298-1588 FAX (631) 298-1588
FILE # 22-46 SCALE: 1".30' DATE: APRIL 9, 2002 N. Y. S LIC NO. 50227 maintaining the records of Robert J. Hennessy