HomeMy WebLinkAboutKosciusko, Robert ,e0StFFOE,tc
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ELIZABETH A.NEVII.LE Town Hal], 53095 Main Road
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TOWN CLERK p .- P.O. Box 1179
CA Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Fax�• Fax (516) 765-1823
MARRIAGE OFFICER � y %N.��� Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER :��1 O�.10
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1918 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : ZOUMAS CONTRACTING CORP.
Address 1 : 18 DEERFIELD DRIVE
City St Zip WADING RIVER NY 11792
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 #R10-98-0120
Name Of Owner KOSCIUSKO, ROBERT AND DIANE
Mailing Address 1 P. O. BOX 335
City St Zip CUTCHOGUE NY 11935
Property Address 1 HORSESHOE DRIVE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 95.00 block 4 lot 18.018
Cross Street COUNTY ROAD 48
Building Permit Number Cross Reference:
Issue Date: 8/25/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
/6C/
00,
OFFOLitc -
ELIZABETH A.NEVILLE �h`1 �t 1 '! Town Hal], 53095 Main Road
TOWN CLERK ; p :4 P.O. Box 1179
•
•• V> Z •
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS • O Pri�• Fax (516) 765-1823
MARRIAGE OFFICER � #
RECORDS MANAGEMENT OFFICER : :Ol ��0�I� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ���081
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: August 19, 1998
Transmitted herewith is a copy of application No. 1995 for a Cesspool/
Septic Tank Construction Permit submitted by:
Zoumas Contracting Corp for Robert & Diane Kosciusko •
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 r commendations:
APPROVE
DISAPPROVE
Comments:
igna u
re/X-1/qie
Dated
I
.
OFFICE OF THE TOWN CLERK 11"' .Of0[// G
TOWN OF SOUTHOLD �'''O� �1 CQG=_ . Application No. l c IS
FLt7ABETHA.NEVILLE,TOWN CLERK i 1 t Construction
P.O.BOX 1179 }y'' ;'�
SOUTHOLD,NEW YORK 11971 . _ Z
Alteration /
Telephones tis W
�O,j- Q��i� $10.00 - Residential V
(516) 765-1801 '-y�1 ��
��' $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE gMY
APPLICANT NAME: ZU0i.4,413 (,/477.4 0774 �r1
e � P
APPLICANT ADDRESS: ( 8 El6/t elcc 0 O(F'(
c ' 4D .4 )2( C2 A . N. 7 / ( 7 ? 2._
SEPTIC ‘,OCESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION i'42-4A1 fy
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTIONIOR ALTERATION:
OWNER OF PROPERTY: ?0Mit. { .4- D 1E 4$CJ v k.O
OWNER MAILING ADDRESS: gO Roo 33c-- Cu ‘tc 4 oq Li 4, ,
OWNER PROPERTY ADDRESS: b/es . Sift) b /e.-
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TELEPHONE
e.-TELEPHONE NUMBER OF CONTACT PERSON: %L9-L1S 70
TAX MAP NO. : Section 09 ( Block p y Lot /e.0/
CROSS STREET: 1(oD/-- aAP « 9
BUILDING PERMIT NUMBER CROSS REFERENCE:
1/
Signature pplicant
RECEIVED BY: jG.1,,
ViClerk'sOffice
DATE: 1 [11C:ti
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IN
MOTE : AL1
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121.00' Fd
C.M.
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51.43'45
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/ Proposed
Well
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I / • 40• Well
2.5•Min. I /5a
Well
�, so- 25' gym. L O f -
L.o t 17 f'-roma
Goroge 4 I:d o d
• om
R",,dance
ILE . SE
TE I co
Hilary s stem is not to be / o z
area.
placed u 'et ``r,, / 7z, I
75'
/ E
.14
T T HOLE
/ 1 .7/ .
/ Propoed
SePt'csTank
/ �
.
m
e75. ,' Proposed
Cesspool W // Cesspool 4 /
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N / o
�` _Yl N
+ t �� C M re, 785>>, -
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.'•,t..:. _ 168.06
�` R= 434. 19' A= �,,.,, ; 46.- ��
\� To 51 �"'"""un,..............„........ Conc. Curb gC 45.56
�<o C ec 50:o = ��
od of
BC 90 `�
V�"`as Asphalt Pavement 4624 9-ca
HORSESHOE DRIVE X
e+ 51.37 .,�
X 48.33 'o4
th
k d' Owner has no knowledge
of Well or Cesspool location.
o Local plumber in residence
t 0 in Lot 17 stated most Wells \ 1
n
rent with Sanitary
Well
•
TD ALL S4NffARY MD WW$ SURROUNDING PROPERTY TEST HOLE
IN EXCESS OF 150' OTHER THAN SHOWN HEREOltirST HOLE DATA AS PER FILE AMP
tE : ALL ELEYAIIONS SHOWN ASSUMED LM1t1M
,: vaS1IMC GRADE
MP sox. SURVEY OF
1
.0, SWO & GRAVEL LOT 18
* moo, IN
MAP OF OREGON VIEW ESTATES
CLAY& LOW SITUATE
CUTCHOGUE, TOWN OF SOUTHOLD
7.0' SUFFOLK COUNTY, NEW YORK
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES SURVEYED FOR: ROBERT & DIANE
PERMIT FOR APPROVALL OP CONSTRUCTION
ONLY ION FOR A SAND & GRAVEL KOSCIUSKO
SINGLE
\ :: ;t1
d;, .. t4o'
/► 4 e
� .A r
•
FOR MAXIIKUM OF_ 15. i'' e • S
EXPO THREE YEARS FROM DATE OF APPROVAL
r FINISHED GRADE FMS• 6241
,,,",9-A 1, MIN. Filed: 4 April, 1975
TMj: 1000-095-04-18.018
t/1:'�' .�, 2' MAX Zoning: A—C
A 1 1i SURVEYED: 23 July,f 998
SCALE: 1"=30'
POOL
I-I AREA= 41,667.42 SF or
0.957 ACRES
X3lAnN GROUNDMITER
GUARANTEED TO:
Richard H. Anderson
TYPICAL CESSPOOL SYSTEM Julie Halpin
Fidelity Notional Title Ins. Co.
N. T. S Town of Southold
t
mFINISHED GRADE
,� ,
1' MIN
v 2' MAX 4.
__�v
r 'y4• 1.
1' --1 -- t, /1'
70 0
DI MIN. TO CESSPOOL
5' ) ° 900 GAL SEPTIC TANK
Cesspool C)
.73
TYPICAL SEPTIC TANK
CO
Guarantees indicated here on shall run
SUFFOLK CO. HEALTH DEPT. APPROVAL only to the person for whom the survey
61
s 24.5 � H.S. NO is prepared, and on his behalf to the
RA, 3g,p1 t th. ce.rr.peny, C overrr ental Agency,
!-:,; ir.y irstitrtic.n, i` listed hereon, cnd
STATEMENT OF INTENT i,; ,h.z css:rr.ees of th= lending institution.
THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS t varcntees are not transtc nolle to
•
MR THIS RESIDENCE WILL CONFORM TO 7HE STANDARDS ldditional institutions cr s_bsequent owners.
X85.77 OF THE SUFFOLK CO •2- OF HEATH SERVICES
/6 S `� Unauthorized alteration or addition to this
t- lw►, wrvey is a violation of Section 7209 of
TOWN OF SOUTHOLD ,he hew ';ark State Education law.
FOR APPROVAL OF CONSTRUCTION ONLY not hAarhy
DATE �c.ples of this survey mop
the land Surreyors embossed seal shat
sj
APPROVAL not be consiuerad to be a valid true
`<O aepy,
SUFFOLK CO. TAX MAP DES/G/NA71ON
D/ST. SECT. BLOCK PCL. •
1000 997 7y 04 18.018 SURVEYED BY:
ONnUER STANLEY J. ISAKSEN, Jr.
P.O. BOX 294
Robert & Diane Kosciusko Nei Suffolk, N.Y. 11/'6
51-- lir
A 7J •,. /
J / ..�i�
Licen-e, and Surve /r
NYS i . No. 4927 ` 98C72C