HomeMy WebLinkAboutSkrezec, Darren SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4306-N Residential Non-Residential X
Fee $ 25.00 New X Existing
Name Of Owner SKREZEC, DARREN
Mailing Address 1 840 CLEARVIEW AVENUE
Mailing Address 2
City St Zip SOUTHOLD NY 11971-0000
Property Address 1 32900 COUNTY ROAD 48
Property Address 2
City St Zip PECONIC NY 11958-0000
Owner Telephone No. 631-000-0000
Tax Map No. section 74.00 block 4 lot 14.003
Cross Street PECONIC LANE
Issue Date: 3/07/06 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
10/02 '06 FRi 12:05 FAX 631 765 6145 SOUTHOLD TOWN CLERK t�j001
•
,,,,, ,,,,,,,4„ -_,
unmanif'A.A�VILL.TY Town Hall,53096 Main Road
TOWN C1S P.O.Box 1179
sur.ourram or V1TA ,STATISTICS AO , C Southold.,New York 11971
MAUTAGE OFFICER '; _� ,s' Fax(691)766-6145
RECORDS MANAGEMENT OFFICER 41 `►�,•''
Telephone(631)7815-1800
FREEDOM OF INFORMATION OFFICER a outholdtown.northfork.net
OFFICE OF TILE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
OPERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @$10 or Non-Residential ?� Application No.4.;0i°
Permit No.
Owner Namt..it/1 t S 1'Pz.e.e_.
Owner Mailing Address F_: 1 ' L..----,
0\-( licil )
Owner Property Address...5_ Cil.)() C' i 4
Owner Telephone No.
Tax Map No: Section- 11 q Block_ dot /V,3
Cross Street re . ,► l U: :�. . ' Y , lei
Please check each that applies: New Construction- _
Alteration to Existing System
Residential „Non-Residential
NOTE: LOCATION ' I BE SUBMITTED WITH APPLICATION. (Locate
building and system; give • arrow • •ximate distance in feet from system to building
and closest road. New co,- , ction may subnu copy o ey with S A approval.)
0-)&-() did° CA'
Signature of Applicant Date
40tReceived by: • �1
• -=
SURVEY OF PROPERTY
SITUATE: PECONIC , n4 c E:i'": r
SU FGLi Ce-,! TY
N
TOM: SOUT OLD h_ 11 {i�Itr s ty
SUFFOLK COUNTY, NY10(15 MAY
24 A t1: 55
a
SURVEYED OS-2ci-2000 F
FOUNDATION LOCATION Oci-21-2004 S
FINAL SURVEY 04-2S-200.5 K
SUFFOLK COUNTY TAX # r
1000-14-4-143
CERTIFIED TO:
I
Damn Skrerec
48 ®�
G.R. 1-
mEDDLE 406.98' r
N 2048'40"E or m. 1
L
e I 1-
w conc. Ii
conc. walk
walk ® Ise i-
DI L—
SUFFOLK COUNTY DEPARTMENT OF HEALTH /ICES �_
I-
APPROVAL OF CONSTRUCTED WORKS ; €
It DAM. 7 2005 H.S.Ref.No.U/bn 2QC) cn rZ
ta
Pavement o
bituminous The sewage disposal and water supply facilites F.
nathave ba .e. to , . i1O
this location, boon inspected and/or „p
w GP certified by this Department c,other agencies oo
0 ft--'•I• r�l- m� and found t o be satisfactory. 70
tP" so. sal 4ineleene i
1,lrulier J Hilbert, I I i
°`° Orrice of W:stews to Management I
_ , x
►� �o, x
�9 e* x
73
11
•
./ well
.4, — — y
la
Uti
0 1 t i
IJI
ro�31 I '
o Oji
Is 'd
1
o
I
I
\ \, . . _____.: .
IILti
1
158.99'
S55°05'20"W------ S55"18'10"W
vs 50.00'
ss z
42
o ~ m
LAND NOW OR FORMERLY OF ¢� LA
yr
BpUER FARMS INC. Ot
o ; to 6
01.
,A
a T
h 73
73
Uri
r�rn
W 7311
s.
p
,`s. x
177.88' v,-
`` S55°05'20"W
•
•
LAND NOW OR pORMERLY OF
------------------
THE METROPOLITAN T�NgppRTATION AUTHORITY
(LONG ISLAND RAIL ROAD)
_
4 f
y,. `( . ,_ \ vbrthrrl:ed eitewtlon or addition e e curvy �:.
I(
nap aa'bB a licensed land sweyore seal b o _
halation of section 120q lot.bb ion 2.L the
- _ 0 *
Nen Tort Stale Education Lan.' t
NOTES: i, •a,,,aoples Fran or r d tnN.a,..,, I
meted man am.cos l or tPe lana wrveyo-e
s stamped seal shall be considered to be valid true 1
N �� wpbs'
MI MONUMENT FOUND 'Certifications Indicated moron signify Na this
( survey de prepared bLoot accordance man the ex-
y tg Code of wrote for tet ..mors adapted
0 PIPE FOUND `r ‘4 M• r k.. , Pero odYo,tracticefor end of Professional
y 6 ,S'� Land Surveyors Sold certificationsoshall ran only
.*4 41/4 "''- -4/
gr bur person for be survey N prpavq t
_... _.- .. :itn .•�..4''''�f.' and on he behalf to the tale canvass gm- f4
had l agency a *Ong institution listed Person,aid t
S,.'"3'"`" +•_ to tPe ossg ere or the tending Mated..Certlrea1.
-
• Ions err not bvrirra to odaltprl institutions
I
TOTAL AREA = 15ci O"1I 5F OR 3.6515 ACRES JOHN` C• EHLERS LAND SURVEYOR
6 EAST MAIN STREET N.Y.S.LIC.NO.50202
GRAPHIC SCALE I"= 50". RIVERHEAD,N.Y. 11901
MI 369-8288 Fax 369-8287 REF.WHp serverte\2000 pros\20-240fin.pro
• „t,/ 44.1a2f I WV se.v.,.,waaedent-e