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JUDITH T. TERRY `` Town Hall, 53095 Main Road
•
TOWN CLERK ® P.O. Box 1179
tis Southold, New York 11971
REGISTRAR OF VITAL STATISTICS V® std` Fax (516) 765-1823
MARRIAGE OFFICER '-_'` Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER --4410
FREEDOM OF INFORMATION OFFICER � �iiAsoI
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1125 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PFENNIG CONSTRUCTION CORP.
Address 1 : P. O. BOX 244
City St Zip WADING RIVER NY 11792
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR NEW SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. SCHD REF.# R10-94-0030
Name Of Owner SEDLACEK, MR. AND MRS. THOMAS
Mailing Address 1 3 BEDFORD COURT
City St Zip SPRING VALLEY NY 10977
Property Address 1 310 SEA-AIRE LANE
(LOT 11 )
City St Zip MATTITUCK NY 11952
Tax Map No. section 100.00 block 3 lot 15.011
Cross Street REEVE AVENUE
Building Permit Number Cross Reference:
Issue Date: 5/11/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY % Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS :�® ,' Fax (516) 765-1823
MARRIAGE OFFICER �,�'/ i�l� Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER =_.. 1 0I
FREEDOM OF INFORMATION OFFICER „��1�ir ��
OFFICE OF THE TOWN CLERK D o R
TOWN OF SOUTHOLD L5
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TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office _ roW��®� DEPT
p o�sour�oLD
DATED: April 29, 1994
Transmitted herewith is a copy of application No. 1164 for a Cesspool/
Septic Tank Construction Permit submitted by:
Pfennig Construction Corp. for Thomas Sedlacek _ •
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 C.
DISAPPROVE
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Ord Dated
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OFFICE OF THE TOWN CLERK cjVFHU(
Town of SoutholdApplication
Judith T. Terry, Town Clerk No. ll h
Town Hall, 53095 Main Road _ tarp ;, r;4;;:< Construction
P. 0. Box 1179 `:_ '
Southold, New York 11971 ,y, `�� � Alteration
�1 ! • Residential
Telephone -�� ��
(516) 765-1801
;Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTF7tCT
APPLICATION
for
RECEIVED
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
APR :2 8 1994
Southold'Town Clerk
Permit No. wy
Fee $
DATE APRIL 21 , 1994
APPLICANT NAME: PFENNIG CONSTRUCTION CORP.-
APPLICANT ADDRESS: 1 GATEWAY DRIVE, P.O. BOX 244 '" , ! '
WADING RIVER, NY 11792
SEPTIC CESSPOOL X
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
NEW SINGLE FAMILY DWELLING
•
LOCATION MAP: Must be-attached hereto before permit-may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION: _" _ r- - -" -
OWNER OF PROPERTY: MR. & MRS. THOMAS SEDLACEK
OWNER MAILING ADDRESS: 3 BEDFORD COURT '
SPRING VALLEY, NY 10977
OWNER PROPERTY ADDRESS: 310 SEA-AIRE LANE, (LOT #11 )
MATTITUCK, NY 11952
TELEPHONE NUMBER OF CONTACT PERSON: 516-929-3456
TAX MAP NO. : Section 100 Block 03 Lot 15. 11
CROSS STREET: REEVE AVENUE
BUILDING PERMIT NUMBER CROSS REFERENCE:APPLICATION IN PROCESS
•
apf.„Iwo plicant
RECEIVED -BY:
Town, Clerk's Office' -
DATE: � _- -
LO \ , TEST:- HOLE . DATA , ' . r
PROPOSED H
WELL 9. - Vzi , TEST HOLE DATA AS PER FILED MAP TEST HOLE ON LOT No. ,1, ' - '.'.?
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PFENNIG CONSTRUCTION CORP. ,...75......
P.O. BOX 244 .
\ WADING RIVER, NY 11792
(516) 929-4023 FAX (516) 929-4272 .
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Wp0 The water supply & sewage disposal sys— _
• terns for this residence will conform to the
.23, standards of the Suffolk County Department • • ;
V
/' GJ of Health Services. r
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i�id�L�o�s LOT ` SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES_
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�� vaa�Nt FOR APPROVAL OF CONSTRUCTION ONLY' _
1.1 116 - _ DAT 0 4 1 H.S. REF.' No. 1r/C-9 o a0 d' -
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,iAPPROVECAAA4 34-1
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FROM FIELD ipQ�'�1� � DATE OF APPROVAL .
' SURVEY OF: -- : : - "- : - . ' :
. LOT 1
'MATE
)OL LOCATION �`
MAP . OF
�s � � SEA - AIRE ESTATES :,
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FILE No. 6780 FILED _ FEBRUART ' 52 1"979 - . - -
,; . . SITUATED ..AT
OpjCHN :,`{
a o° MATTITUCK
PPVEM'Nl ° o TOWN OF SOUTHOLD � ,:
C - s��o p"E SUFFOLK COUNTY, NEW YORK .. -
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0,1°14.8p-- T•C• W
0'' S.C. TAX No . 1000- 100- 03- 15 . 1 1:'
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,OO' SCALE 1 " =30'
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\--- MARCH 15, 1994
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45.4"\ I
gl 1 CERTIFIED TO: .,
4` O' THOMAS SEDLECITECK '
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r/%j% ';,�'�,;, o \ , AREA = 44,298.67 sq. ft. -
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:$7z �/,"r" y/ '. 1.017 ac.
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,.rs;/,',r;�,/ /�-;,�,'/;'� NOTES:
;',1:40%,;,;,4.,#0;4,y ,, ,h1. ELEVATIONS ARE SHOWN THUS:
� � � � � to
46.67 % 2. ELEVATIONS ARE REFERANCED TO DATUM.'',/4b(144,41,44,45,4,4 /'r� ,t�,r ,� I, x EV AN' ASSUMED M
`;l"ii',;,y 60.00;,''>/ J • _
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PREPARED IN ACCORDANCE WITH THE MINIMUM - .
,, STANDARDS FOR TITLE SURVEYS AS ESTABUSHED
BY THE L.I.A.L.S. AND APPROVED AND ADOPTED
`�;'t , FOR SUCH USE BY THE NEW YORK STATE LAND
' TITLE ASSOCIATION.
1.,L',-; P,eE OF'Neh,
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N.Y.S. Lic. No. 49668
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Jose h /� • I n a e o UNATHORIZED ALTERATION OR ADDITION
Fs';;`+; - TO THIS SURVEY IS A VIOLATION OF
d SECTION 7209 OF THE NEW YORK STATE
J1.",''- of EDUCATION LAW. -
s}' - j Land- Surveyor
urVeYor COPIES OF THIS SURVEY MAP NOT BEA
RING
THE LAND SURVEYOR'S INKED SEAL OR
EMBOSSED SEAL SHALL NOT BE CONSIDERED
TO BE A VALID TRUE COPY.
I.. -; - , GUARANTEES INDICATED HEREON SHALL RUN •
,t.,;. - - ONLY TO THE PERSON FOR WHOM THE SURVEY
;t- IS PREPARED, AND ON HIS BEHALF TO THE,
_4,;- Title Surveys —' Subdivisions — Site Plans — Construction Layout TITLE COMPANY, GOVERNMENTAL AGENCY AND
i,:, LENDING INSTITUTION LISTED HEREON, AND
nr TO THE ASSIGNEES OF THE LENDING
INSTI—
t,tTUTION. GUARANTEES ARE NOT TRANSFERABLE.
: . = PHONE (516)727-2090' Fax (516)722-5093 -
OFFICES 'LOCATED AT . - - - MAILING ADDRESS -
THE EXISTANCE OF RIGHT OF WAYS THE LOCATION OF WELD
' Square- AND/OR EASEMENTS OF RECORD, IF OBSERVATIONSCAND/OR
,i-''10,',,, One,,Union P.O. Box 1931 ANY, NOT SHOWN ARE NOT GUARANTEED.
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