HomeMy WebLinkAboutDoroski (3) • OS�FFOt,tco
ELIZABETH A.NEVILLE tsTown Hall, 53095 Main Road
4••• �y�,
TOWN CLERK t o P.O. Box 1179
REGISTRAR OF VITAL STATISTICS V. t, Southold, New York 11971
MARRIAGE OFFICER 1� Fax(516) 765-6145
RECORDS MANAGEMENT OFFICER ‘‘. ?f61 Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER '� i��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2141 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : SCHEMBRI HOMES INC.
Address 1 : P. O. BOX 163
City St Zip WADING RIVER NY 11792
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 #R10-99-0133
Name Of Owner DOROSKI
Mailing Address 1 C/O SCHEMBRI HOMES INC.
P.O. BOX 163
City St Zip WADING RIVER NY 11792
Property Address 1 HARBOR LANE
City St Zip CUTCHOGUE NY 11935
Tax Map No. section 136.00 block 1 lot 12.000
Cross Street PIERCE ROAD
Building Permit Number Cross Reference:
Issue Date: 8/27/99 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
FOLA. r'
4�
ELIZABETH A.NEVILLE h
\? 6.OG Town Hall, 53095 Main Road
'lam
TOWN CLERK ; o < P.O. Box 1179
REGISTRAR OF VITAL STATISTICS .y Southold, New York 11971
MARRIAGE OFFICER �
O Fax(516) 765-6145
RECORDS MANAGEMENT OFFICER y�fo ��� I�� Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER = ' 1 X00I
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: August 25, 1999
Transmitted herewith is a copy of application No. 2227 for a Cesspool/
Septic Tank Construction Permit submitted by:
Schembri Homes for Doroski
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:
Signa
8l),_(_ /cq
Dated
OFFICE OF THE TOWN CLERK ,�'' �Ffptk
TOWN OF SOUTHOLD ,•ts k\ Ct2Gy Application No. 62-(262- 7
ELIZABETH A.NEVILLE,TOWN CLERK •
P.O.BOX 1179 : L Construction , —
SOUTHOLD NEW YORK 11971 •
z p T ; Alteration
Telephone `.. . rei $10.00 - Residential ./
(516) 765-1801 ----4k 41 1 , $25.00 - Non-Residential
,
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ /0 G /
DATE 0 f
APPLICANT NAME: S CLe \�JTJ
APPLICANT ADDRESS: (A4\O-- fbJ'l. 14
17
Uv /'t - - / / 7, 1.—
SEPTIC CESSPOOL (--------
DESCRIPTION OF PAPOSEVONS UCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUC ON OR A TERATION:
OWNER OF PROPERTY:
OWNER MAILING ADDRESS: C / 0 f 4aci e
OWNER PROPERTY ADDRESS: `dCe «1)v 444 _
TELEPHONE NUMBER OF CONTACT PERSON: Cl—q 9 `
TAX MAP NO. : Sectio / 3 ` Block / Lot io•_
CROSS STREET: Ot,t-e.A,
9
d--- /411'41- -
BUILDING PERMIT NUMBER CROSS REFERENCE:
/- - ." -.-7.Z
Signature of Applicant
RECEIVED BY:
�n G�rk's�eJ
DATE: aS'fry
TEST HOLE DATA
(TEST HOLE DUG BY McDONALD GEOSCIENCE ON JUNE 7, 1999) SURVEY OF
°. LOTS 57, 58, 59 & 60
01
/���� ovLOAM OL
'4 DARK BROWN sANMAP OF
� BRAWN Laver SAND Ski EUGENE HEIGHTS
.,,,ALD;
JACOBF DBY I
BOWERS
FILE No. 856 FILED OCTOBER 29, 1928
, '` 4Pg'°' > SITUATED AT
F
CUTCHOGUE
N/0/
/�/8 Y�ALiN,ACE ���•15'°�► cgs"' °�" SSD TOWN OF SOUTHOLD
OA"F BuNc ` SUFFOLK COUNTY, NEW YORK
$ GA OWE ►n°�"r...;:".9_'--_,.. F %" i
S.C. TAX No. 1000-136-01 -12
1 yr ..2'S.o.iE ;E8 SCALE 1"=40'
'f ' �a: JUNE 15, 1999
lk- 3 2\'\o, i "`""leC LOT i- til x AREA = 17,660.86 sq. ft.
N 5. U- o� �,a 0.405 ac.
` 30 / / �c" to x�z p
,`� FS1 f,Lui'' 0�a(n '^�
• > v\k\-1,LAO C't9 C •:, N c.Cgf tri"
a 'ti `t ``ire j_- - 1,01' /- �Si'. Z0 G�6 v0-`
/ ;: 2115 / y9
tr Mr /-
a • • w 4 LOT
r
i-
19)- i- - 0-1. / NOTES;
< -/, / T HO� " 1. ELEVATIONS ARE REFERENCED TO AN ASSUMED DATUM
: / Q EXISTING ELEVATIONS ARE SHOWN THUS:Z0.0
d• / 111: 4 2. MINIMUM SEPTIC TANK CAPACITIES FOR A 1 TO 4 BEDROOM HOUSE IS 1,000 GALLONS.
• 1n,�p'�Y CD) CP4A 1 TANK; B• LONG• 4'-3- WIDE, 6'-7' DEEP
O OT V F-$C • F, tIO / 3vet . MINIMUM LEACHING SYSTEM FOR A 1 TO 4 BEDROOM HOUSE IS 300 q ft SIDEWALL AREA.
a "* 1U A,1' '. L 01,NIS°R • woo, / 1 POOL: 12• DEEP. B' dia.
14
- `e�+- , • .`10 PROPOSED EXPANSION POOL
. J ,• Y 1 114'
i PROPOSED LEACHING POOL
i t1
°�T H' °,1'F-_ .�1 PpJFy' OV- we PROPOSED SEPTIC TANK
,• `I.1 LLL "'
(� J Z�' 0 _/ 4. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD
`4 , 1 J _�` % OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS.
Ae, . 4 , • s. ri, ._ - O'C
` PREPARED
FOR• • ,�f •
WH TANDMMMM
ADOPTED\ 1 / `\ ,. %
-484 --
/ :`_:. :
YORK STATE LAND
-------1\. ---- \
VpG \ . �S�pH 14112i11.4.
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IF
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SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES �� `�'d �•
PERMIT FOR APPROVAL OP'CONSTRUCTION FORA • . N W N.Y.S. L c. No. 49668
1rLAvntoRlzED ALlE11ATI0N DR Aoofrl>N
TO THIS SURVEY IS A VIOLATION OF
Gn ANIGRLE FAMILY RESIDENCE ONLY LSEC110N 7200 AW. Jose
THE NEW YAR` STATE
DATE v .No `�_1 "^O COPES OF TP SURVEY MAP HOT BFMING Jose ,► h A. Ingegno
Hs REP THE `ANDSE ''HAL INKED E CONSIDERED Lan • Surveyor
OR
EMBOSSED SEAL SHALL NOT BE DEEMING
TO BE A VALID TRUE COPY.
APPROVED /- TIONS INDICATED HEREON SHALL RUN
ONLY 10ERTIF0 THE PERSON FOR WNW SURVEY
_—~ 1101 THE
Title Surveys - Subdivision - Site Pons - Construction Layout
FOR MAXIMUM OF MS ASSIGNEES LLTHD I AND
TO INSTI-
TUTION. CE TV1CATK��aTRANSFERABLE. PHONE (516)727-2090 Fax (516)722-5093
E(PIRES THREE YEARS FROM DATE OF APPROVAL THE EXISTENCE OF MONT OF WAYS
AND/OR EASEMENTS OF RECORD, IF OFFICES LOCATED AT WILING ADDRESS
ANY, NOT SHOWN ARE NOT GUARANTEED. One Union Square P.O. Box 1931
Agnboque• New York 11931 Riverhead, New Yak 11901
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