HomeMy WebLinkAboutOrlick, Paul (2) %Suf
ELIZABETH A. NEVILLE ` � Town Hall, 53095 Main Road
TOWN CLERK H 2 P.O. Box 1179
ivy
REGISTRAR OF VITAL STATISTICS O 1 Southold, New York 11971
MARRIAGE OFFICER �� y �ie°' Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER _ 41 * 14 Does Fax
(631) 765-1800
FREEDOM OF INFORMATION OFFICER ,•i" 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. 3274 R Residential X Non-Residential
Fee $ 100.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : ORLICK, PAUL
Address 1: 30 STERN COURT
City St Zip FARMINGDALE NY 11735
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY RESIDENCE
FINAL APPROVAL REQUIRED FROM THE SUFFOLK COUTNY HEALTH DEPARTMENT
Name Of Owner ORLICK, PAUL
Mailing Address 1 30 STERN COURT
city St zip FARMINGDALE NY 11735
Property Address 1 1300 LECTION DRIVE
City St Zip SOUTHOLD NY 11971
-Tax Map No. section 580.00 block 2 lot 1
cross Street KENNY'S ROAD
Building Permit Number Cross Reference:
issue Date: 1/27/05 Elizabeth A. Neville
Southold Town clerk
(TOWN SEAL)
_ ,p,,,... ` 2.74
O
y
G
GELIZABETH A.NEVILLE ,�� yd` Town Hall, 53095 Main Road
• TOWN CLERK P.O.eei/ Z $ Box 1179
REGISTRAR OF VITAL STATISTICS ``Oy� O��e� Fax (631) 765-6145
',, Southold, New York 11971
MARRIAGE OFFICER
0.
RECORDS MANAGEMENT OFFICER Ol alit �►a ,,. Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ,,,,,. southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: January 4, 2005
Transmitted herewith is a copy of application No. 3418 for a Cesspool/Septic Tank Construction
Permit submitted by:
Paul Orlick
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: ..,- 4-4-.7‘9, 52# 140 /
W.#.1 <a
i
7-V‘f-e-•'4,--( e -•€4.-7 ,
Signature
00 7 0.'
Dated
r . ,,i/iii,..,
��,%�QsOFFO(,�C'
ELIZABETH A.NEVILLE e o4 \ Town Hall, 53095 Main Road
TOWN CLERK ',h`1` P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER
O Fax Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER =- i4%,
sk 01 Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER = 'J 1 * ,a' southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT •
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @$10 or Non-Residential @$25 Application tItt
Permit No.
Applicant Name Q ti"( 0 g 1( C G
_____
pP /��
Applic,iitt Mailing Address i) S (-e,r-AJ CT
a SIA 7 (7 3 s-'
Septic Tank ✓or Cesspof
Brief Description of Prop sed Construction or Alteration s W _C,IV
Location of Proposed Cons ction/ teration:
�1 r
Owner of Property: V/ Jt F )� (,
C�
Owner Mailing Address: 3 0 .c'--e r7() C Q d Kr-
raro,( dct.,. /123--'
Owner Property Address: /,3 0 0 f Le c ZJd/ rivc__
St7r1ol
Name and phone number of contact person
Tax Map No:/Dov Section SST Block a, Lot
Cross Street 4E.A1//I 7..s ,`).
NOTE: LOCATION MAP MUST B :'WITTED TH APPLICATION. NEW
CONSTRUCTION REQUIRES SUR H D ARTMENT APPROVAL
f r //?4,5---
Signature of Applicant Date
Received by :
SURVEY OF PROPERTY
SITUATE: SOUTHOLD
TOVNN: SOUTHOLD
SUFFOLK COUNTY, NY
SURVEYED 03-10-03,
PROPOSED HOUSE 02-18-04 �Q
AMENDED 06-01-04, 01-06-04, `
OS-11-04, 11-03-04, 11-22-04
SUFFOLK COUNTY TAX #
SUFFOLK COUNTY DEPkilaIT OF HEALTH SERVICES
1000-58-2-I
CERTIFIED TO: PERMIT FOri APPROVAL OF CONSTRUCTION I;DR A
SINGLE FAIKELY RESIDENCE ONLY
PAUL ORLICK p�
COMMONWEALTH LAND TITLE DATE /0 / c 7 HS REF.NO. ( ' —� '�°
INSURANCE COMPANY /, ;
APPROVED !� /.... 4 Test Hole
— ` // I 06/001-04
FOR r XEMUM OF DEDROOL °,..)
/ anddq
E3CI %S ITIREE YEARS FROM DATE OF APPROVAL Loodm
2'
Pole
Brown
Medium
to
G°arSe
Sad
el
5.4'
water
�2 h
•
�/� Polo
//`�/` / •jam Brown
^V // 11eo4'4710 Medium
�` . / PO I N' to
/
civsono
12.
r� '/ '/ Rpa ?of /RFO
C` `�, /
ht'
/ / ,' ,
d�'��4 // / / / /
- / / / / // / //,,,,• V'�,' <�
4�
/ / / ' / /!ry•/ vgti
/ • / /•////(/4 ' e o
/ / `.tl, / / /:.// :/,' .lo` /i C)//°,,
/ / / / / — /, • .# , o
/ • cit eir
/ / / /d/ /, /I , / r � enol
•
/ // /,,, ,t:/• , s, A114.41. / 4,
•
/ ///i" ,/ ' / I />:\
/
,.
Q
/ctiV / 1.• • /
a' \ \ / ` �/ /��•0 .SI •
/ /V' I• \\/ ,,
.It'�����, 40 / .\ U 0 ° � '/
q a / \l /
, e / \ _ink, or/
04)
n o `
ms`s �iEoey �°�\./ ��7 �'�//
9 0/ / \. . . / `� //
•
�o 7/ 7 , NIP,// /\ �2-
/
.c0* ►y /h.,
* \1 .
Y�'�
s,4se \
0'v
•LAIRD t_
,' C
-
NOTES: a "'
o PIPE FOUND ti r-t...,'
ELEVATIONS REFERENCE N6VD' 2q "'
landscape tie or equal �
FEMA FLOOD ZONE ANNOTATED FROM FIRM retaining wall
•' `"F.F. =10.5'+
MAP # 36103C0154 6 DTD MAY 4, IggB ��`,;
tkv el = 8.5' GRADE ELEVATION 8.5' E,___ '
COASTAL EROSION HAZARD LINE ANNOTATED FROM EL=7.1 INV=6.4 INV=6.6-1r INV=7.1' _iii
DEG PHOTO # 56-566-83 SHEET 8 OF 4g DTD 8/2g/88 rode ave lPeleachingPoolo dachhgpool —Z se is INV.
ab°va pool Paottom EL=4.6 1200 gal. 7.4
t.
PROPOSED PORCH TO BE CANTILEVERED WITH NO 6ROUNDVNATER ELEVATION 2.6 EL=2.2
SUPPORTS TO BE WITHIN 100' OF LONG ISLAND SOUND
'Unauthorized alteration or addition to a survey SEPTIC GR
AREA = 16,221 S.F. OR 0.37 ACRE ° bearing°licensed land surveyor's seal O55 SECTION N.T.S.
violation of sect.7209,sib-el/vb.],of the
New York State Education Lav'
SUFFOLK COUNTY WATER AUTHORITY MAIN IN STREET .°Ny copies from''":;T::
gkol of this.crvey
marked woth m orl94nl of th.la�tl RNs JOHN C e EHLERS
wiped,.al�l�a ..o to t0 �. LAND. SURVEYOR
T-ertmcatbrro indicated ed hereon signify that this
sy was p epa ed N occandare ge the ex-
lsthhy Nad.or Stateatee 1°rat •y d 6 EAST MAIN STREET N.Y.S.LIC.N0.50202
GRAPHIC SCALE 1"= 301 °� = • Associationao:'41—.1 ProfessionalM�°'
a s�„„1to tit »pr.paren- RIVERHEAD,N.Y. 11901
611. 111%.111111.1.1. governmen-
t tet^' �'•••rut,-.t.v:n listed 369-8288 Fax 369-8287
t'a.aerottrasfera w'to , lInstitutions REF.\\Hp server\d\PROS\03-128.pro
11/11/100. io.ceaw, N.rwN91909.-labore .4