HomeMy WebLinkAboutKrupski, Frank C yic
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cf' Town Hall, 53095 Main Road
�O •�•• P.O. Box 1179
���1 1 t',,•' Southold, New York 11971
JUDITH T.TERRY FAX(516)765-1823
TOWN CLERK TELEPHONE(516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 649 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : FRANK J. KRUPSKI
Address 1 : BOX 1687
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
NEW SINGLE FAMILY DWELLING WITH CESSPOOL SYSTEM.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES ON 9/24/90.
Name Of Owner KRUPSKI, FRANK J.
Mailing Address 1 P. O. BOX 1687
City St Zip MATTITUCK NY 11952
Property Address 1 ALDRICH LANE
City St Zip LAUREL NY 11948
Tax Map No. section 125.00 block 2 lot 5.000
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 10/15/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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. Town Hall, 53095 Main Road
BLDG. DEPT. ;oe '' �-04� P.O. Box 1179
TOWN OF SOUTHOLD --;'701 )\`'ol. Southold, New York 11971
JUDITH T.TERRY „, o�� TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
To: Southold Town Code Enforcement Officer
From: Linda Cooper, Southold Town Clerk's Office
Dated: Ocotber 9, 1990
Transmitted herewith is a copy of application No. 664 for a Cesspool/
Septic Tank Construction Permit submitted by:
Frank J. Krupski
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: Ca.. �,, � ce � Q. i 1$4,1e11•?.l
ts-v) ck\ .\\c-x0
RECEIVED n
OCT 1 o 'FA) Ohm, _sem.-.►�-cX---
Signature
?awn Clerk v ''(144 j o gVq o
Dated
OFFICE OF THE TOWN CLERKc3VFFO(Ir
Town of Southold I 0� C4 1
Judith T. Terry, Town Clerk t ;` Application No. ��T
Town Hall, 53095 Main Road Construction ./
P. O. Box 1179
Southold, New York 11971 0 0-'''
�>J Alteration
Telephone 0! 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 $ /D
DATE 1990
APPLICANT NAME: rrAh K 1-. krp��
APPLICANT ADDRESS&)cg2d 7 rncti-klidi /(A YMISQ.
SEPTIC CESSPOOL —
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
N &-&) /f26IS��
LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: Ke k,;
OWNER MAILING ADDRESS: 3 p 434,e- i '7i /144:14-1-61c) P.V. Ws-A,
OWNER PROPERTY ADDRESS: AIdriciel 1.-41•4_ / Lithe Ii 4J (
TELEPHONE NUMBER OF CONTACT PERSON: „29k- 5--"03t,
TAX MAP NO. : Section / 5 ,O081ock g, Q p Lot _S---
CROSS
S"CROSS STREET: VY)j r A j
BUILDING PERMIT NUMBER CROSS REFERENCE:
Sig ure of Applicant
RECEIVED BY:
R erk's Office
DATE:
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30322/ 4V7.... - SURVEY FOR
• FRANK KRUPSKI a DOREEN KRUPSKI
'.
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVlCEB LOT NO.5, MAP OF RICHARD J. CRON
AT LAUREL DATE. AUG 20, 1990
FOR APPROVAL OF CONSTRUCTION ONLY
TOWN OF SOUTHOLD SCALE: I"=loo
(�(� SUFFOLK COUNTY, NEW YORK NO. 90-0607
DATESEP 24 1,9(5�r . NO. ( 0 //D w WMUTHOR12ED ALTERATION OR ADDITION TO THIS it OF NE* 1
-,l,/ �/ ' SURVEY A v10LEDUC OF SECTION 7209 OF THE OP. `O
NEW YORK STATE EDUCATION LAW
APPROVED J 0 COPIES OF THIS SURVEY NOT BEARWG THE LAND . p,0 M• P„ 7*
SURVEYORS INKED SEAL OR EMBOSSED SEAL SHALL
NOT BE CONSIDERED TO SEA VALID TRUE COPY yy :ice , C.
GUARANTEES INDICATED HEREON SHALL RUN ONLY 10 T
II
HEALTH DEPARTMENT-DATA FOR AP-ROV.L TO CONSTRUCT THE PERSON FOR wTHE SUREEY IS PREPA ,1
ANO ON HIS BEHALF TO THE TITLE COMPANY,GOOEDVERN- ,
Ty
* NEAREST WATER SAIN_MI ' *SOURCE OF WATER PRIVATE_PUBLIC_ MENTAL AGENCY AND LENDING INSTITUTION LISTED jA-"'V 7�
SKIFF CO. TAX MAP DIST 1000 SECTION 125 BLACK LOT 1.18 HEREON, AND TO THE ASSIGNEES OF THE LENDING `'';,
*THERE ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION GUARANTEES ARE NOT TRANSFERABLE
OTHER THAN THOSE SHOWN HEREON TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT (/ lb• 45893
N THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE OWNERS P
WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT *DISTANCES SHOWN HEREON FROM PROPERTY LINES AirW tO 0♦
Of HEALTH SOIVICES. TOEKI3TING STRUCTURES ARE FOR A SPECIFIC .iI
APPLICANT PURPOSE AND ARE NOT TO BE USED TO ESTABLISH
(,, I� •r '� 1 / PROPERTY LINES OR FOR THE ERECTION OF FENCES
ADOREfS i :._ - e7 �i4 ,4 AA• •i /17 5isZ
' a , A00 WY
r YOUNG a YOUNG RIVERHEAD, NORK
NOTE: A= STAKE `''"5
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF ALDEN W.YOUNG,PROFESSIONAL ENGINEER •
SUFFOLK COUNTY ON SEPT.30, 1985 AS FILE MVO. 7975. AND LAND SURVEYOR N Y.S.UCENSE NO 12845
HOWARD W.YOUNG, LAND SURVEYOR
o *TIE LOCATIDM co WELL(W),SEPTIC TANK(STIS CESSPOOLS(CP)SHOWN HEREON N.Y.S. LICENSE NO 45893 '
+ ARE PROM FIELD OBSERVATIONS MOOR DATA OBTAINED FROM OTHERS