HomeMy WebLinkAboutFilipkowski, Karol
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STA'I'ISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hall, 53095 Main Road
P,O, Box 1179
Southold, New York 11971
Fax (631) 765.6145
Telephone (631) 765-11l00------------
southoldtown,northfork.net
,
OFFICE OF THE TOWN CLERK
TOWN OF SOUTH OLD
TO:
Southold Town Building Department
MAR :3 0
FROM:
Michelle 1. Martocchia, Southold Town Clerk's Office
DATED:
March 29, 2006
RE:
Cesspool ConstmctionlAlteration Application
Transmitted herewith is a copy of application No. 3577 for a Cesspool/Septic Tank
Constructionl Alteration Permit submitted by:
Karol Filipkowski
Please review the application and location map and advise if this office may issue the permit.
Please complete the form below and return it to me, Thank you.
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I have reviewed the application and location map ofthe project cited above and make the following
recommendations:
APPROVE
J./
DISAPPROVE
Corom""" ~it~-c~~.;;~~~
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Dated
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ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT Q'~FICER
FREEDOM OF INFORMATION OFFICER
.~ Town Hall, 53095 Main Road
P,O, Box 1179
Southold, New York 11971
Fax (631) 765-61415
Telephone (631) 7615-1800
sou tholdtown, northfork, net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential@$IO 1/'- or Non-Residential @$25_
Application N03.sJJ
Permit No.
Applicant Name
){R~OL
-;:I} IfkOe)5kf
Applicant Mailing Address PO f!O;<' 3 -) ('
(tAAlu':Jftoe /}t_-7. lie; 3 s .
Septic Tank_or Cesspool V, (~ / i.
Brief Description of Proposed Constmction or Alteration 0/:/ ;-!r-;uJt. O~r
Location of Proposed Construction/Alteration:
Owner of Property Ka,YJL ;;Z;~jOtJ)h '
Owner Mailing Address: PO (l.,(,/X 36-6
-Iu ~/, "t; Il/j /Ir,yc>-
Owner Property Address: /'5 ;:i; /7 (j)r .
0f70fllIlO/
(
Name and phone number of contact person
Tax Map No: Section j-3
Cross Street /770.//1 lid .
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION !REQUIRES SURvEY WITH HEALTH DEPARTMENT AP-PROV AL
'//"7 /~,;w.;;< /, '7 ~/2cfo6
Signatirre of Applicant / Date
Received by:~~~bL
Block () 5 Lot
()2
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PROPOSED SEWAGE lJt$f>OSAL \..
i' ) ~~ &:=-~ ~R
/ -;r;-i 6' BELO" FOOt.s, IrlOO "".
fT PRE:CAST CONCRE'tE SEf'T/C
~~.!! '/ TANK. BOTTOM OF LEACHfoIG
~ / FOOt.S TO BE 2' ABO\ll!
." -n 1 GROUIf>II'ATE1l,
CROSS SECTION
SEPTIC SYSTEM
.
SURVEY OF PROPERTY
AT ARSHAMOMAQUE
TOWJ\/ OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
1000-53-05-02
SCALE: 1 "==20'
JUNE 13, 2002
SEPT. 9, 2002 ( cerlificollon )
Mo-r. 9 2005 (130/-1
/'Ii,... /(,. ~ooS (r."';''''''')
Sept. 16; 2005 (oddillons)
c..e,~~ '-.0.-. \t
HSE ~~ ~ ~"lI'
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NOTE'
SUBSURFACE SEWAGE
DISPOSAL SYSTEM DESIGN
BY' JOSEPH FfSCHETTI, P.E,
HOBART ROAD
SOUTHOLD, N. Y. U97J
(6311 765 - 2954
CERTIFIED TO'
KAROL FILIPKOWSKI
FIDELITY NA nONAL TITLE INSURANCE
COMPANY OF NEW YORK
S~FFQLK COUNTY DEPARTMENT OF HEALTH SIRVIC.S
PERMIT FOR ApPROVAL ell' CONSTRUCTION FoR A
SINGLE FAMILY RESIDENCE OHI.V
\)!TE~i\C)'Io H.S. REI', No. \?""\()-()'i- Q\~\'
i\.PPl'lO\!ft.__~~'" ~'""''''''t,~
Fu" ,,^,~'\I\~ . ~ B.DJlOOM.
EXPIRES THRl.._."r"Y -<OM ,)ATE OF A"PROVAL
NnTFS,
I 0.<'1 fo.<'1ilio.r with the STANDARDS FOR APPROVAL
AND CONSTRUCTION OF SUBSURFACE SEVAGE
DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES
o.nd will o.bide by the conditions set forth therein and
on the perl"lit to constr'uct,
:SC 01/.5 Ref It
RIO'04--0/'l G.
RAIN RUNOFF
HSE,PORCH & OECK . 2014 sq, /1
2014 . 0./7 . I- 342 cu,lt,
342122.3 . /5 VF
Provide 4- ."drains 6'(1 H 4 or aqual
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The loco. tion of wells o.nd cesspools shown hereon are
froM fielel. observo.tions o.nd or data obtained froM others,
~LOO,b ZONEX
~1rz.M,'- .=.GI03.COI59G
@:. \"RO\", ~VI\-"Ol~
(or NUMBERS REFER TO 'MAP OF SOU)
;](EO IN THE SUFFOLK COUNTY CLE:Rk
AUG, e9, 1963 AS FILE NO, 3853,
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~~-i:;; N.YS, LIe. NO, 49618
[CONIC S V[YORS, Pc.
(631) 765 - 5020 FAX:(63J) 765-1797