HomeMy WebLinkAboutGevinski, Peter ,,/II--
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JUDITH T.TERRY �'_� y1�� Town Hall, 53095 Main Road
TOWN CLERK y . P.O. Box 1179
Pi? Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ‘ O ��, Fax (516) 765- 1823
MARRIAGE OFFICER .=y ct I�
RECORDS MANAGEMENT OFFICER Q( ,1 $ ,��
Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER • ------ Ogifr s
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1618 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PETER AND LISA GEVINSKI
Address 1 : 169 HERRICKS LANE
City St Zip RIVERHEAD NY 11901
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.
Name Of Owner GEVINSKI, PETER J.AND LISA A.
Mailing Address 1 169 HERRICKS LANE
City St Zip RIVERHEAD NY 11901
Property Address 1 405 WENDY DRIVE
City St Zip LAUREL NY 11948
Tax Map No. section 128.00 block 5 lot 1 .000
Cross Street PECONIC BAY BLVD.
Building Permit Number Cross Reference:
Issue Date: 3/20/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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7.34
i Town Hall, 53095 Main Road
• aP.O. Box 1179
1� Southold, New York 11971
JUDITH T.TERRY 1 ‘``•%••••••••••••
�� TELEPHONE
"•••� (5161 765-1801
TOWN CLERK
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: March 11 , 1997
Transmitted herewith is a copy of application No. 1689 for a Cesspool/
Septic Tank Construction Permit submitted by:
Peter and Lisa Gevinski •
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:
RECEIVED
Sig nature'/
MAR 2 1997
-3//i/ 2
Dated
Tcsw C:57-
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OFFICE OF THE TOWN CLERK ,c,\\FFOLte yG
Town of Southold � Application No. � �p<J T
Judith T. Terry, Town Clerk � ,<
Town Hall, 53095 Main Roadcr3 j Construction ✓'
P. O. Box 1179
New York 11971 ye ►, Alteration
Southold, 1�-
Telephone _OI 4t Residential ✓
•
(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 $
DATE 3 - )1 - eJ -7
APPLICANT NAME: �eiLcrr J r L75-t. GPJ/ 5A
APPLICANT ADDRESS: g;615. .�
"16't
SEPTIC d CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
Allesil 110u3C +,f'HI See I C .5y6 7Le4 ha 3727Li'C 74.44
Gnd pem IS
LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY : $.uier 54 II, GeufnS
OWNER MAILING ADDRESS: Sa-e.
OWNER PROPERTY ADDRESS: `/05 tlencyD c
y
L4if. N. k -- --
TELEPHONE NUMBER OF CONTACT PERSON: -702c›)_ , 3 Q F.3
TAX MAP NO. : Section op Block) ,�)Jr' Lot
CROSS STREET : Ppc , 1171 vi,_
BUILDING PERMIT NUMBER CROSS REFERENCE:
ig ,. ure of Applicant
RECEIVED
Town le k's Office
DATE: ?� /l T�� _
,... .� \.__..:...,.._ .Y.,..__.
° S.C. TAX No. 1000-128-0`
°D.e ,�po0 CC*5' SCALE 1"=20'
ce.?°1)
F iolSP%fl r'o. MAY 17, 1996
ti 1 fat W SEPTEMBER 17, 1996 REVISED AS PER S.C.D.H'
��Q,S �PC,P __ ® w0• SEPTEMBER 27, 1996 REVISED AS PER S.C.D.H.S. I.
°q ' CERTIFIED TO: AREA = 22,244.7
ev1, y0N 4P ` 0 SCTIC, Inc. 0.511 oc
TITLE No. 330941934
<�p�F 'Sp 0v ' v d� rA LISA G GEVINSKI
NSKI
h,1.1_, '-I4 Ni ,f),,,,,,. „...,, .a. E
(�. . yi4 .ti j,/f, 1. ZONING USE DISTRICT: R-40
o44'..°' �•< 2. EXISTING ELEVATIONS SHOWN THUS:2Q.O ARE REF:cit
10 )f 11 PROPOSED FIRST FLOOR ELEVATION SHOWN THUS:
x PROPOSED FIN SHED GRADE ELEVAPROPOSED INVERT ELEVATION TIONTSHOWN TCI
I,;. $C DPI.
3. MINIMUM SEPTIC TANK CAPACITIES FOR A I TO 4
HEARy� I TANK: 8' LONG, 4'-3" WIDE, 6'-7' DEEP
Z \1j .. F'BVI 4..MINIMUM LEACHING SYSTEM FOR A I TO 4 REDRO
(J" ';2 POOLS; 6' DEEP, 8' dla.
8.3S.C.D.H.S. REFERENCE No. RIO-96-0076
let %.C.DEPT.OF '.:."-•:q;
liv TN SERVIKS. .;1s.•
N SUFFOLK COUNTY DEPARTMENT OF HEALTH SERV!,
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�A PERMIT FOR APPROVAL OF CONSTRUCTION FE3
S G E FAMILY RESIDENCE ONLY
war
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c �� A, PPROVED /-4' A"
0
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FOR MAXIMUM OF BEDROOMS
0z f c^ EXPIRES THREE YEARS FROM DATE OF APPROV,s
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