HomeMy WebLinkAboutGrodski, Stanley ,,,,, ,D0,,,
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CP • �. Town Hall, 53095 Main Road
V Off-�°' P.O. Box 1179
-='yo i 4. `�� s Southold, New York 11971
JUDITH T.TERRY =-'.--,,,,,,i0-I 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. 633 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : STANLEY AND ALEXIS GRODSKI
Address 1 : P. O. BOX 141
City St Zip RIVERHEAD NY 11901
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 7/17/90.
Name Of Owner GRODSKI, STANLEY AND ALEXIS
Mailing Address 1 P. O. BOX 141
City St Zip RIVERHEAD NY 11901
Property Address 1 TUTHILL ROAD
City St Zip NEW SUFFOLK NY 11956
Tax Map No. section 117.00 block 2 lot 20.001
Cross Street NEW SUFFOLK ROAD
Building Permit Number Cross Reference:
Issue Date: 8/14/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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SOUTHOLD s.r3 — 7 - I Town Hall, 53095 Main Road
`'Q Fffb Nc- 1 P.O. Box 1179
"le' :'1 It Southold, New York 11971
JUDITH T.TERRY '���,,ii1.�� 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: August 6, 1990
Transmitted herewith is a copy of application No.649 for a Cesspool/
Septic Tank Construction Permit submitted by:
Stanley and Alexis Grodski
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.
i
-
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE X
DISAPPROVE (�
Comments: ct.., jt....dt•4.c��.4�. cM c 7„eS2A, I
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Signature MOVED
9 4\9 o AUG 14 19iU
Dated
Town Clerk Sow*
•
OFFICE OF THE TOWN CLERK OslFair ,.
Town of Southold
Application No. `.
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road g
Construction
P. O. Box 1179 0 + J• Alteration
Southold, New York 11971
Telephone 01 t ' ` 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 $ /b
DATE 7-42` -Cf o
APPLICANT NAME: �"77&J1,El Ah� 'XIS 67tvi.S'kr
APPLICANT ADDRESS: O, , 'ox /'-{/
A VE4 /SEA- / Ili y 1110 /
SEPTIC CESSPOOL A446 47bkreLSAIL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION6/[7 /Q,1
I/
A & O 14J6 �Q OCR o i O A -7-Coo �S'/NG//���� f� /e/
LOCATION MAP: Must be attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: c 7 WLEl (.7,. Sk-
OWNER MAILING ADDRESS: /2O ilOx /4/
✓EAhl E-A-f R/.7- //`O/
OWNER PROPERTY ADDRESS:-707,46( ,W- ` 411537,0
Y,21-24/26(jk)(0,5*-J/O6
01.6-x•sJTELEPHONE NUMBER OF CONTACT PERSOI�(,t�rn: X3,146
TAX MAP NO. : Section /07 - Block 2 Lot ,20. f
CROSS STREET: AJE t� Jr- to A'Ofr16
BUILDING PERMIT NUMBER CROSS REFERENCE:
��%.. *.1L IIIL
Si,.. . ire •1 A.pli a
RECEIVEDYt flielittiti
Clerk' ice
DATE: ms
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* ..EARES T NATER MAIN_M _ *SOURCE of WATER PRivATE—PUBLIC— "WO/7i
cJFF CO TAX MAP DIST IQQ.O_SECTION 1,7 BLOCK.Z_LOT-&
• •HFRE ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY •
•rIER THAN THOSE SHOWN HEREON. r__ -- — _____ __ ______..__ ____ _
• 'HE WATER SUPPL1 AND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE
' LL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTYDEPARTMENT
p HEALTH S7ES__/,( ió- SUFFOLK COUNTY DEPARTMENT O/ HEALTH SERVICES
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:DDREss . 50 /j� -- - f'�_.----2// FOR APPROVAL OF CONSTRUCTION ONLY
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VOTE : • =MONUMENT '
ELEVATIONS ARE REFERENCED TO N.G.V.D (MSL 1929) 40)
4PPROVED Aj
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.THE LOCATION OFNELL(W),SEPTICTANK(ST)&CESSPOOLS(CP)SHOWN HEREON
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ARE FROM FIELD OSSER VATIONS AND OR DATA OBTAINED FROM OTHERS.
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R i 1 YOUNG YOUNG
• MAY / 0, 1990 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK
et
91 ` 5,8 ALDEN W. YOUNG HOWARD W. YOUNG
PROFESSIONAL ENGINEER AND LAND SURVEYOR
/i. LAND SURVEYOR. N.Y.S. LIC. NO, 12645 N.Y.S. LIC. NO. 45893
\.., / = SURVEY FOR:
;NAUTHORIIED ALTERATION OR ADDITION ' OF
'HIS S.IRVEY r 4 VIOLATION OF SECTION TC ° STANLEY GRODSKI a ALEXIS G- • aIP- NFFr ro
'209 OF •..E NEW YORK STATE EDUCATIO Q W
AW
COMES •11 THIS SURVEY MAP NOT BEARI/� r O�►
THE LAND SURVEYOR'S INKED SEAL OR9111k. - : . *I T.
'MSOSSED SEAL SHALL NOT BE CONS:DE- ti
-0 8E A VALID TRUE COPY �\
AT NEW SUFFOLK GU• "A TEED
j
STA EY ROD• . - - SRO,•Kl
3LAR4NTEES INDICATED HEREON SHALL RUN NOR FO- 8 K -UST CO *ANY
.NLY TO THE PERSON FOR WHOM THE TOWN OF COMM, AP10 LE -UR' CE CO.
SURVEY ,1 PREPARED,AND ON HIS BEHALF SOUTHOLD SEIZIN : - 8
THE T.TLE COMPANY,GOVERNMENTAL
44 AGENCY AND LENDING INST!).:TION LISTED BY
HEREON,AND TO THE ASSIGNEES OF THE SUFFOLK CO., N. Y. ,� .s '�
LENDING INSTITUTION. GUARANTEES ARE YYr �.
NOT TRANSFERABLE TO ADDITIONAL SCALE. , 30, I DATE: '
NSTIT.,rI
oNs CR SUBSEQUENT OWNERS, FEB.23,I989 NO. :9-0119