HomeMy WebLinkAboutPawlowski Paul OFFICE OF TIt~ TO*PgN CLERK
TOWN OF SOfJIItOLD
ELIZABETH A. NEVILLE, TOWN CLERK
P.O. BOX 1179
SOL~FHOLD, NEW YORK 11971
Telephone
516) 765-1801
TOWN OF SOUTHOLD
Application No.3
Construction ~, ~/'~
Alteration
$10.00 -Residential J
$25.00 -Non-Residential
SOUTHOLD WASTE~VATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
RECEIVED
APR ! 4 2¢~
$~.~"~1(I f~wn Clerl~
Permit No.
Fee $
DATE
APPLICANT NAME: ~'~/~ ¢'~
APPLICANT ADDRESS:
SEPTIC ~CESSPOOL
DESCRIPTION OF PR~OP, OSED COI~8~TRUCTION O'R ALTERATION
/
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRL~CTION OR/CkLTERATION:'
OWNER MA L,NG ADDRESS: ¢'/5/
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO.: Section l/ ~ Block
CROSS STREET: ~¢)f ~/~-C~ ~[.,
BUILDING PERMIT NUMBERCROSS REFERENCE:
~/~~, / / Sig~,a~u're of Applicant/
RECEIVED
BY:
~ Town Clerk's Office
DATE:
44
4~
42
o
42
~' 6 8 9 ~0
PROPOSED
2520 SO F1
BblLENNG
FIN FLR EL 46~5'
N [ 3'30" W
47
NEC, K. t~OAI~
PUBLIC WATED LINE
'~ANI TAI~"F' ~'f~TEh4
%ALE I' :
45
S 23' 56'10 E
44
45
IF [XPANSlON POOL
_§' DIA X 12' DEEP
~ ~EAC~NG
SEPTIC
153
47 ¸
PLAN
149 ~.,,
45
o:
46
,, 15O 00'
Fli'4 FLR ELE'¢ 4ti()
/
LIAr HINf~
(lO
DARK BiRr '~WN
t;IL T Y Lt)AM
I ()L)
BROWN
LOAMY ~;ILT
FI~ ltl
T E,::,, F iTtOL E
These phns have been ~.~ewed ~. ~ confoemeum wtth 9uffdk ~
supply ~d aew~ge ~isposal. Rega~iess of ~ ~Js~ . ,' ~1
SITE DATA
T()~' AL AREA
SANITARY DESIGN CALCULATIONS
t B~9(~I FLOW
PROPOg:D 6UIL[~'qG
T()TAL AREA -
( ~)FFK'.E A~A LEah THAN
(~AL I~)Lt%TFgAL ~;f'A( E
k
' '1
I/
E,
5ANITAR'f' LFAC, HJN~9 POOL
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