HomeMy WebLinkAboutCichanowicz, Frank 0,, F0/4>O--
p
; Gr
ELIZABETH A.NEVILLE ���=00 Town Hall, 53095 Main Road MI';
TOWN CLERK o - P.O. Box 1179 !°
Wt Southold, New York 11971
REGISTRAR OF VITAL STATISTICS Fax (631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER QlAsi �a�'i� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ° ��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2300 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : FRANK CICHANOWICZ
Address 1 : 255 LUPEN DRIVE
City St Zip CUTCHOGUE NY 11935
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 #R10-99-0269
Name Of Owner CICHANOWICZ, FRANK
Mailing Address 1 255 LUPEN DRIVE
City St Zip CUTCHOGUE NY 11935
Property Address 1 155 HALL'S CREEK DRIVE
City St Zip MATTITUCK NY 11952
Tax Map No. section 116.00 block 7 lot 1 .000
Cross Street NEW SUFFOLK AVENUE
Building Permit Number Cross Reference:
Issue Date: 14/21/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
300
,ol�s�FFO(,�Op_` iG
ELIZABETH A. NEVILLE �� ti� G* ; Town Hall, 53095 Main Road
TOWN CLERK ` P.O. Box 1179
;` Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER ` 1i �1 Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER � Ql � Fax
(631) 765 1800
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK r �1
TOWN OF SOUTHOLD APR 9 -5„
1
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: April 19, 2000
ii
Transmitted herewith is a copy of application No. 2388 for a Cesspool/
Septic Tank Construction Permit submitted by:
Frank Cichanowicz
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:
ignatu
l 2t) Ito
Dated
OFFICE OF THE TOWN CLERK
,,'"""
Town of Southold •�' C,��FI 4
Judith T. Terry, Town Clerk �•13•
.� u-6,„ Application No.
Town Hall, 53095 Main Road ; Construction
P. O. Box 1179 v rn Alteration
Southold, New York 11971 tri .`
Telephone _+40° �Q���' $10.00 - Residential -z
190
(516) 765-1801 / 4 1,••' $25.00 - Non-Residential
.,••
, �
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
F'tl
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
}
Permit No.
ii
is
Fee $
DATE 4/18/00
APPLICANT NAME: Frank Cichanowicz
APPLICANT ADDRESS: 255 Lupen Drive
Cutcho,gue NY 11935
SEPTIC g CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
Install new on-site sewage disposal facility.
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: j
OWNER OF PROPERTY: Frank Cichanowicz
OWNER MAILING ADDRESS: as above Iss
OWNER PROPERTY ADDRESS: 155 Hall's Creek Drive
Mattituck NY 11952
TELEPI-IONE NUMBER OF CONTACT PERSON : 734-5800
TAX MAP NO. : Section 116 Block 7 Lot 1
CROSS STREET: New Suffolk Avenue
BUILDING PERMIT NUMBER CROSS REFERENCE: AIM.
4 1 frei -
lin
Signaturejf pplica t
%ames E. Fi /erald, Jr.
RECEIVED BY : for Frank Ci anowicz
Town Clerk's Office
DATE:
SURLY OF LOT 32
MAP OF HARBOR VI E1N AT MATTI TUCK FE^FC.EC
SEPTIC DETAIL , ,FcNs
51 MATE MTTITUGK not to scale e_
cr^F peg
TOWN OF SOUTHOLD , ;� EL - ex l!tlna grade max.2 I'
SUFFOLK COUNTY, NY max. min.I' -
min.i' inv.. over inv.fe 15.9 i'
e1=12 a er 15.2 aoo as l. �
MAP OF HARBOR VIEW AT MATTITUCK Inv..
AUG. 21, 1a87 AS MAP * 83T1 15•I___ ------------------ sep�N mn et�lt
lexhina tGn tank k�4'C
_ min.p'
:'.deep i'4"per ft
Nerii,.. e'ai.
SURVEYED 11-02—�1a separation
AMENDED II-Ib-aa, .
Gy'otrld water
12-23-aa, 02-IS-0043°' 81 - 1, ,
SUFFOLK COUNTY TAX # � 0. $ �' -
1000-IID-1-I Q� /. � ��,� .1 ‘LI: /
w4
CERTIFIED TO: — �e TEST HOLE 1
BRENDA GIGAHANOWIGZ / s66o3e `°'" 11
FIRST AMERICAN TITLE / •: s'
OF NY. / • ; 141
sanacmd
/ Co) i
■ MONUMENT r- `'aet I y ,
FOUND a�� I te .- I; 1 —
Y 's rs�a I�' '(fl 1tt
AREA = 4 a,540 S.F. OR 1.14 ACRES v ^ / �� \kry .r' I I S lJ 5'
1
c.--iv 1 • t 0
ELEVATIONS RDTR TO MSL NGVD '2a ;R ;' P/ op $-__ -
.iw A11 _ _ �P o•• r to I .L' iti�(J1 ,t
y /- ems' °cf I; ti sVI
gj \ryQ I LOit 32 61 •
I _L00
J �t sod
i
J \ey� 9)14 P'' 13 Ti-I of itdp1/ test hole 'A � U—I ;J;, tar, i
/ high tae i N Qi ; Y—s r�rtoum
HATER 15'
Vi I -�..uto NIr t 1
W I+1� r/
� ;; o a I l 1 ,,1 i 1
_-' ct # W li I vp. _ I ro I y • L 3.
r—e J +
(NJ ii 1
t+.1
`i ' I to 1 :J� JL f
rrr.r Nes 1 • -`,.- ' , I i y 1 ,.-. tF
cel---- �p o I � I ; 1 41.1. int o0
Y .,.ts I- e1:19 �i IaI I ,l �: ;O •
'- D e1e18 saw --1-
xs 1 1 N87°07'50"W
acw SUFFOLK COUNTY D eARi�T OF HE• .TH SERVICES ! 1313.38'
I
a.a i-�
L'' PERMIT FOP APP'OV\L Or CO = I y tl
l ^ 1, Unauthorized•lter•tlon o a.t to a sur,ev " '
SINGLE
7�[ yt �7; �W }� 1 , ego bearing,licensee land 3 a seal I!e
SINGLF.r Yt '11'1LLli "pEESIDEN : t.";741.51 '� t violation of section 20q s o o .n z. or the
1 ,.--",.......6' N,e Yort Stat<E]u.glon ue.' I
C� 1 bn1Y ctOlf!' ° '
g
DATE, ` '0 R • �- - ! e,.,et alt•an thconsloo]of toe lend
•S RE NO. _ _ !�F NE y ae•.Ceb seal snail be cOnstOereo to
I� 1 • 1• / ,•
• C/� f 'certlfleetzens ladieted hereon signif.tnat tnis
e , survey was bra:ergo In•ccoro•nce ate the or-
APPROVEIS ._. ; i,AL '.
AL. iI isting food of filatei ce for tane rprof gdtote0
®� f by tn!Nee yrs,Stet!Assuta thetIonSur e.prooreoareo.
• Land Surveyor:. Shod clrtillc•tl Ons shall run ons.
FO� �.'U OF Se. 11 OMS ; _�, �, , to the Denote for Moe tee surrey Is oreoer<o.
\\ /i _ • and On nt!Denote t0 tef Iltl!COepM:, ggv<rnMn-
• [s1 agency MI lending lnstitutlon listed hereon, end
Dwelitng with Public. water Service a ` i t the,eiennot tr tea lending InotnIon01utIOn [ertivice-
EXPIRESTHREE YEARS FROM DATE OF APPROVAL # `:h *• do,.re tr.n,fer.b,.tt.Deltltna Ingtltutitn,
•�, =`' oma; JOHN C. EHLERS LAND SURVEYOR
e`F+ 4/0 t'%` 440-11 6 EAST MAIN STREET
N.Y.S.LIC N0.50202
GRAPHIC SCALE 1"= 40'
•'-rFo LAND SJQ�/1 RIVERHEAD,N.Y.11901 1
611111111611111
'�•�....•0 369-8288 Fax 369-8287 W.D:VOBS\99-276SD