HomeMy WebLinkAboutDzenkowski, Andrew SCUTHCLD VAST EWTER D SPCSAL PERM T
OC STRJCTI CN CR ALTERATI CN PERM T
SEPTI C TAN( or CESSPOOL
Perm t Nb. 4168 R Fesi dent i al X Nbn-Fisi dent i al
Fee $ 10. 00 Septic X Cesspool
PERM T I SSIED TO
Name : ANDREW& J ESSI CA MEW/SKI
Address 1: 332 VWCX] NS SIi-tl
City St Zip GREENPCRT W 11944
Eescr i pt on of Proposed Const r uct i on or Al t er at i on
SAN TARP SYSTEM FCR SI MOLE FAM LY DI'ELLI NG
APPRO/ED AS SIJBM TIED AND AS APPRJJED BY TI-E SLFFCLK OCtNrY EEPARTMENT
CF FEALTH SERA CES. Fl NAL APPRCf/AL FEW RED FROM TI-E SLFFCLK CONN
FEALTH EEPARTNENr. REF #R10- 13-0043
Farre a Omer ANDREW& J ESSI CA MEMO/SKI
Mai I i ng Address 1 332 VW GI] NS STREET
City St Zip GWEN:CRT NY 11944
Property Address 1 1050 SCUTHCERN BLVD
a ty St Zi p EAST MNR CN NY 11939
Tax Map Nb. section 22. 00 bl ock 1 I of 4. 000
Cr oss St r eet CEDAR CR VE
Bui I di ng Per nit Number Cr oss Ref er ence:
I ssue Eat e: 1/02/ 14 El i zabet h A Novi I I e
Sout hold Tow, CI er k
,,,,,o��gUFFO1�-�o
ELIZABETH A.NEVILLE,MMC ��I f� 4 Town Hall,53095 Main Road
TOWN CLERK % p ; P.O.Box 1179
1 ti 2 $ Southold,New York 11971
REGISTRAR OF VITAL STATISTICS Fax(631)765-6145
MARRIAGE OFFICER `=4* 0. i Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER of illi #„0 www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER „.,,,,.0�
OFFICE OF THE TOWN CLERK --------777—\1-_-
TOWN OF SOUTHOLD ��
TO: Southold Town Building Department QCT1 6 2013
FROM: Carol Hydell, Southold Town Clerk's Office L—____. �-�
DATED: October 16, 2013 --
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4168 for a Cesspool/Septic Tank Construction
Permit submitted by:
Andrew & Jessica Dzenkowski
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.
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments: II �,
/
24(.4..(4,„4.7.
Signature
/� z
Dated
�///iii�•
4FOL4
ELIZABETH A.NEVILLE le 41 4` - „Town Hall,53095 Main Roa'
TOWN CLERK a Q "__.- P.O. Box 1179
REGISTRAR OF VITAL STATISTICS W Southold, New York 11971
MARRIAGE OFFICER . Z 1 Fax (631) 765-6146
RECORDS MANAGEMENT OFFICER y 40` Telephone(631)7654800
0'�
FREEDOM OF INFORMATION OFFICER � �� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TOWN OF SCUTHWififHOLD WASTEWATER DISTRICT
BUILDING.DEPART
Southold,N.Y. 11971 APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @$10 or Non-Residential @$25 Application No. 1116Y)
Permit No.
Applicant Name D 2_ Y1 k 5
Applicant Mailing Address 33 2 Got (ii in rPt i'1 -p6 r
ri ) t .fL(
Septic Tank or Cesspool V
- Brief Description of Proposed Construction or Alteration
Ne inc) 0611-0''Ciqn't-sULI
Location of Proposed Construction/Alteration:
Owner of Property: A-1n d v e 1)2.5 51e 14 .1.2
Owner Mailing Address: R 3 'Z LC
euipoir f Ili i1 V-1
Owner Property Address: I O SCS �j pt t_` e r n 15 L I} A
• 1s rr &e- l h r. 1 I `i 35
4100-
p p ego ' A �Z� kOws �
Name and hone number of contact person g sqr
Tax Map No: 000 Section 22_ Block I Lot Li 7c g r
Cross Street Ce ct V' ori
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL-
. ,r,; /0_ Z2
gnature of Applicant Date
Received l : 1 106V
! I SURVEY OF LOT 13 N
AS SHOWN ON "MAP OF AQUAVIEW PARK"
FILED JULY 30, 1971 AS MAP NUMBER 5621 W ' E
SITUATE: EAST MARION 11!..
TOWN: SOUTHOLD
SUFFOLK COUNTY, NYPLOT NG S
WE
SURVEYED 06-I 0-20 13 LOT 7
LOT G VACANT
SUFFOLK COUNTY TAX# DWELLING +wEu
1000- 22- i - 14 - VA ON IN•PECTION REQUIRED
FOR SANI ARY SYSTEM
CERTIFIED TO: _ BY REAL DEPARTMENT — o
ANDREW W DZENKOWSKI SOUTHERN BOULEVARD EL=37
D' '
JESSICA MARIE DZENKOWSKI
EL--,.-38 ASPHALT PAVEMENT 3c4
3,1-^
N:-049' 0" 95.11L=3&; 586°49'20"W I:6.46'
EL=3' •s , •'•TEST HOLE
k's),
T- ,,,,,(3,,,* oy v.w O
-0 ``off P �'�, 'F' Ao
iF„O 1 LO ! 9OPN ;',
Q D.W -___-1
DRAINAGE SYSTEM CALCULATIONS: ��TT _
2 :.. m. 24.( _
ROOF AREA=1493 SQ. FT. s I' PROoOSED to -
1491 SQ. FT.X 0.17= 253 LOT I ? Li of HousE$GAR O DWELLING ¥
253/42.2= G VERTICAL FT. OF 8' DIA. LEACHING POOL REQUIRED V`'L'NTb
28 0t'.--'2"112"" d
PROVIDE(2)8' DIA.X 3'STORM DRAIN POOLS u DW O , � .2
O LOT 13 5 ° b i j 2 ? i.+- e,4
DRAINAGE SYSTEM CALCULATIONS:
DRIVEWAY AREA=1687 SQ. FT. c0 BUILDING ENVELOPE 0 SUFF.CO: HEALTH SERVICES
1493 SQ. FT.X 0.17= 286.79 Z o -20.• s.T.
erncE OFV . g T MGT.
286.79/42.2= G.79 VERTICAL FT. OF 8' DIA. LEACHING POOL REQUIRED o 11 v�
PROVIDE(I)8' DIA. X 3'* (I)8'X 4'STORM DRAIN POOLS oo
a.
I
NOTE: LOTS SHOWN AS THUS LOT#j el=3� PROPOSED WELL o,WELL TD LATERAL MUST BE i 1
AS SHOWN ON "MAP OF HIGHPOINT AT EAST MARION" ,�;
FILED JANUARY I I, 1984 FILE NO. 7680 N88°I G'20"W Z • 9 x • k A - .J 4_
McDONALD GEOSCIENCE EL=39'
II 4
TEST HOLE DATA Q CCC
WELL CM ift.ig i
M.
DARK BROWN LOAM OL DLWELLNG _ `_ I �" CD
- I NOTE:SEPTIC 150+FROM PROPOSED WELL LOT I l' 1 i I a O
PALE BROWN SANDY SILT ML W r Line(s) MUST Be Inspected B} - VACANT ow
----7' Suff•k County Dept. O , Ith Services. �� °� o
LOT 3 Call :52-5700, 48 Hours In Advance ;
BROWN SANDY SILT 5M DWELLING o Schedule Inspec ion(s�. . ' �'(
NOTE:SEPTIC 150+FROM PROPOSED WELL14 :14 -l 0 3
.
----20' \ . —
Cii 2 la
' },
BROWN FINE TO COARSE SAND SW SiD 1 , ; X W
- ---28' N l�.
COMMENTS: NO WATER ENCOUNTERED A # A `' Wm
II► h
,,.� NE ,,,,,yce
® 0 N
NOTES: 14��'G/' Of
= oblation at;elation ,w-daW n Z of Vt.. __j a_
+ V G. New'fat State Education law'
® MONUMENT FOUND JOHN C . E h LE RS LAND SURVEYOR ;�Q� � ''E"`� °�� ,,, withorigin,ofthe sin ; 0
y e �• i; stamped..d dray be considered to b.valid tree M
Area = 32,844 Sq. Ft. : t "1 *; =One t
Area = 0.7539 Acres I* l` : • tifications indcated hereon dynny mot ml. e •
'Y.4.A,i_�. serv.y cos +t oeeandanw him Ur.a-
6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 ; �, > < ... ¢ \ w cede of . Land saw adapted
,.l �-
/ !i'.,.i '4 *� by
d SNee Y s. Sdd ort lcotbm dar re i and
GRAPHIC SCALE I "= FSO' RIVERHEAD, N.Y. 1190 I 369-5288 Fax 369-8287 �'F,61.61%.111111.1.1111111 -11 o. I,S 502"I�J ,+` ork State AseaclotIon of Professional
t' and an M behafftothe is°moo,X
longlslancllancIsurveyor.com and
=.F�LAND•;�;�+' t. governmen-
to air,,;, of 1. sties,."�,1
....•- tons are not tram/wdde to additional YrdRutbns
-y • mahout a
I
_ II
I