HomeMy WebLinkAboutRoslak (2) ,,/iiia...
COMA 1
s �` Town Hall, 53095 Main Road
Q �• P.O. Box 1179
-�_®1t �`�r►r� 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. 650 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : CHARLES ALLEN CONSTRUCTION
Address 1 : MANAGEMENT CORP.
City St Zip LAUREL NY 11948
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 8/7/90.
Name Of Owner ROSLAK, JOHN AND MAUREEN
Mailing Address 1 P. O. BOX 195
City St Zip CUTCHOGUE NY 11935
Property Address 1 TUTHILL ROAD EXTENSION
City St Zip SOUTHOLD NY 11971
Tax Map No. section 55.00 block 6 lot 15.00$
Cross Street ORIOLE ROAD
Building Permit Number Cross Reference:
Issue Date: 10/15/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
.,,c____,
t . a d .._ owgto,,,,,,,,,,,, 6 Se
199 - < `: .�
r
,v--110:7A-----i,- + • Town 53095 Main Road
p BLDG ®EPT t � '�-�. ;�" �, .� ,,
1.s �' i,r Hall,
gOwN OF s14E g.t-D
,® �- ��. P.O. Box 1179
" '®/ � y'��i�. Southold, New York 11971
JUDITH T.TERRY
-4"-t"...•••0000 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: ' October 9, 1990
Transmitted herewith is a copy of application No. 665 - for a Cesspool/
Septic Tank Construction Permit submitted by:
Charles Allen Construction Management Corp for John & Maureen Rgslak
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: .A. ► ° go ��e.
9\,\ck 10
\CL�C�'� � WuSignature
.
Signature
Gam Clerk 00Aiord I,Dated ®\� 1�
OFFICE OF THE TOWN CLERK c,Vf-FOLD`,"
Town of Southold O� � { "'. : OG
Judith T. Terry, Town Clerk
Application No. � J�
Town Hall, 53095 Main Road "—� Construction v
P. 0. Box 1179 w
Southold, New York 11971 , Alteration
Telephone x [ Residential
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
D SOUTHOLD WASTEWATER DISPOSAL DISTRICT
NT 09 an APPLICATION
5a�oG 14om C 0o for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $/Q
DATE 1oPjao
APPLICANT NAME: 0-4- j /UL -ISI. COUS-17 6� t_ _ G 1 P
APPLICANT ADDRESS: ?do_ - (
LAOOG L ! kV I (q(-)
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
SI WO L'E HAI-41U" Db-)eU--11
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: 11...1 4- I`-`j4,_� 1 % �
OWNER MAILING ADDRESS: 4).() • f � 1c/ 5
LSE,
OWNER PROPERTY ADDRESS: cc LAtJE
TELEPHONE NUMBER OF CONTACT PERSON: CI-VG ASU JJ
TAX MAP NO. : Section Block Lo Lot . 1-, ----)45:/
CROSS STREET: 00(ADL {�� �
BUILDING PERMIT NUMBER CROSS REFERENCE:_
-?),Q I
tCE HiAkitqc-12
Signature of Applicant
RECEIVED BY: ( .
TownClerk's Office
DATE: 70 - 2 -��
1Y ,
0., .
1 ''
, ‘
_,,_
..., ,
DWELLING
dubdivision
- DWELLING
Mapof Yennecott Park"
Suffolk County File No.51187
Lot 49 Lot 48 `oo'`
I ..
aG
6�'
O�
N.88°57130'1E. 139.50' EL=20.5
x --
EL=22.2 I EL=20.8
10801 _
Lot12 c N
^(0 Area = 22702 s.f. 0 I --i
N I al YH
C
�1
E-
r x I I—.
Lot II I c°'o w I
oP
(VACANT) DWELLING
INANE 1 co C)
I . of 1 21m 100
_ 490_ -TL � 1 0
- 1 - N
�1^Ir 5�vo i9 j.
iD 7.; I 51.1i, S,PV- (D CO 0 I
o
I. 0,I \j, c P'`) /#.03411).r5)
•
EL-225 :c.od
ck
s82°:'1q.....‘‘•� , — —lEla2L5
WATER MAIN I m
1y1
OLEE X 22.6 pRlV
ORI E rn
z
0
ORIOLE�x .
z .
cn ; .
. o ,
(VACANT)
z
SUFFOLK�c COUr.I DE?A r11<< E{1r OC rpt T1 SERVICES
_ l/fl A r�1O11���_ C cit!'gnT1 ll 1J�1(1 ' C
I!
Sint° rain..; I'�.;IC...1'Le Only
DATE 7 � REF. : ------
LC'D7,1%1Lf
a':4
'S0:0),PIF n2 FL��\' r,b r ,I E A PFROVA
SURVEY FOR
MAUREEN ROSLAK
SUFFOLK COUNTY DEPARTMENT OF HEALThi SEK`,',L. LOT *0.12, "HIGHPOINT MEADOWS , SECTION TWO
AT SOUTHOLD DATE . JULY 24, 1990
FOR APPROVAL OF CONSTRUCTION ONS`;' TOWN OF SOUTHOLD SCALE• 1"= 50'
SUFFOLK COUNTY, NEW YORK NO• 90 - 0538 ,
;iE PIS REF. NO._ •UNAUTHOR12ED ALTERATION OR ADDITION TO THIS
SURVEY R A VIOLATION OF SECTION 7209 OF THE
NEW YORK STATE EDUCATION LAW
M COPIES OF THIS SURVEY NOT BEARING THE LANDPiE OF NES
&PPROVED SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL 0 ).
NOT BE CONSIDERED TO BE A VALID TRUE COPY0\
PAD w
*GUARANTEES INDICATED HEREON SHALL RUN ONLY TO
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE PERSON FOR WHOM THE SURVEY IS PREPARED O `Y �0 ,
AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERN- .
4.N NEAREST WATER MAIN_MI 4 N SOURCE OF WATER PRIVATE_PUBLIC_ MENTAL AGENCY AND LENDING INSTITUTION LISTED W--- 0M PUFF CO TAX MAP DIST 1000 SECTION 55 BLOCK _S_LOTp/o15.1 HEREON, AND TO THE ASSIGNEES OF THE LENDING --i,1,11-l
ta:11.
*THERE ARE NO DWELLINGS WITHIN 100 FEET OF TNIS PROPERTY INSTITUTION GUARANTEES ARE NOT TRANSFERABLE s.. ; ,
OTHER THAN THOSE SHOWN HEREON TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT
N THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE OWNERS
1F DI STANCES SHOWN HEREON FROM PROPERTY LINES
WILL.CONFORM TO THE STANOAROP OF THE SUFFOLK COUNTY DEPARTMENT TO EXISTING STRUCTURES ARE FOR A SPECIFIC !�
OF HEALTH SERVICES 1 PURPOSE AND ARE NOT TO BE USED TO ESTABLISH .F` •` GI
/�� o o 1 -�� (-J""[ / (� PROPERTY LINES OR FOR THE ERECTION OF FENCES � D SUR
APPIICANT� - =1v�_� NJ i"IC- IY+�'1 1 1J J1-r. � VF �
ADDRESSP.O. a.7x ?�1) L --C_ '.l I P�"T- `'�......_
E - • • a YOUNGYOUNG OSTRANDER AVENUE
URIVERHEAD, NEW YORK
NOTE: •= MONUMENT&= STAKE '/
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF .+ ALDEN W YOUNG,PROFESSIONAL ENGINEER
SUFFOLK COUNTY ON MAR.19,1990 AS FILE NO.8911. ; AND LAND SURVEYOR N Y.S UCENSE NO 12845
a, HOWARD W.YOUNG, LAND SURVEYOR
m *THE LOCATION OF WtLL(W),SEPTIC TANK(STIS MOWN OWN HEREON N Y.S.LICENSE NO.45893
a ARE FROM FIELD OBSERVATIONS MO OR DATA OBTAINED FROM OTHERS
'RANDIS & SONS INC. -