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HomeMy WebLinkAboutPawlowski ELISABETH A.NEVILLE ti�O Town Hall, 53095 Main Road TOWN CLERKy P.O.Box 1179 v, P �� Southold, New York 11971 REGISTRAR,OF VITAL STATISTICS ® �� Fax (631) 765-6145 MARRIAGE OFFICER ‘-_-4 y �I RECORDS MANAGEMENT OFFICER �_�Ql t oiii Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER r�� southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT CONSTRUCTION OR ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. 2890 R Residential X Non-Residential Fee $ 10.00 Septic X Cesspool PERMIT ISSUED TO: Name : PAUL PAWLOWSKI Address 1 : PO BOX 814 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 #R10-98-0075 Name Of Owner PAWLOWSKI, PAUL Mailing Address 1 PO BOX 814 City St Zip CUTCHOGUE NY 11935 Property Address 1 895 HOLBROOK LANE City St Zip MATTITUCK NY 11952 Tax Map No. section 113.00 block 6 lot 14.005 Cross Street RIGHT OF WAY Building Permit Number Cross Reference: Issue Date: 9/24/02 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) 11 ®, ,,.,-,--.i.,-•,.-,.i„i®� ELIZABETH A.NEVILLE 111�� ; Town Hall, 53095 Main Road '' TOWN CLERK :4 ; P.O. Box 1179 REGISTRAR OF VITAL STATISTICS a' °� ,� Southold, New York 11971 MARRIAGE OFFICER ,.' `� 0 Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER '�_ ® �� '' p _ � �1� 111 Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER --'s...-...0"s'/ southoldtown.northfork.net s } tw!' =' , ��11; : OFFICE OF THE TOWN CLERK ;,,ti TOWN OF SOUTHOLD RIG3W\\ p2002 _\\-j U\.,_ \ , tar--- c S�o�u old own Building81 0 Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: August 29, 2002 Transmitted herewith is a copy of application No. 3000 for a Cesspool/Septic Tank CONSTRUCTION/ALTERATION Permit submitted by: Paul Pawlowski 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. Linda J. Cooper * * * * * * * * * * * * I have reviewed the application and location map of the project cited above and make the following recommendations: APPROVE DISAPPROVE Comments: Maintain required setbacks from adjacent wells,buildings,property lines and water Bodies. EXCAVATION INSPECTION REQUIRED. is � f Signature 0 9/, 7----A 2.— Dated • .yam OFFICE OF THE TOWN CLERK • ,,,,�� ,,,,,� F.i.i7ABETH NBVIL E,TOWNCLERK . 619e0 Tovvn OF SOUTHOLD `�� oS�FFOik�oG_ • Application No. P.O.BOX 1179 Construction soumow,NEW YORK 11971 I:=3 Alteration ct� hone P .� $10. 00 -Residential Tele ag (631:) 765-1800 = > t,�, '� $25.00 -Non-Residential TOWN OF SOUTHOLD . SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for CONSTRUCTION or ALTERATION PERMIT SEPTIC TANK or CESSPOOL Permit No. Fee •$ DATE APPLICANT NAME: i%1 Z,/L AlAtt/L CJJ tI APPLICANT ADDRESS: Y O /c ell SEPTIC /CESSPOOLt;ertio6or /UV //93 DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION N&-Ze.) 107f4--- • LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONST UCTION OW ALTERATION: OWNER OF PROPERTY: //VGP4-e./../‘62ee/.</b OWNER MAILING ADDRESS: pc' j57)( fig OWNER PROPERTY ADDRESS: �9 " i-41A-E r-r7z //9 z.- TELEPHONE NUMBER OF CONTACT PERSON: 63/1- 73V-76. 97 TAX MAP NO. : Section /13 Block ©2 Lot /1"/"-S.-- CROSS 7JCROSS STREET: l2/LL67S ./�hFj ePa-1 BUILDING PERMIT NUMBER CROSS REFERENCE: Signature of Applicant RECEIVED BY: Town CI e k's Office DATE: o2 9/D �?/ 1 a ,_ "MILLER'S OP SURVEY OFF PROP &1.29•°0•E (Bums RIGHT LANE) WAY„ - cl SITUATED AT 328 so- 2.00. MATTITUCK TOWN OF SOUTHOL ,�o '�' �_ " , SUFFOLK COUNTY, NEW a • '. ,' S.C. TAX Wo. 1000-11 3—06 o o SCALE 1",----50'•F 1.11 OCTOBER 21, 1997 MAY 8, 1998 PLOT PLAN a WI _ - JUNE 5, 1998 REVISED PLOT PLA O O/ aiaMuRA AREA = s1.2253.2n4 sq. ft. I I limit SLY RISIDSNCE ONLY wl • �✓ O( 4-- -q oro • CERTIFIEDCOMMONWEALTH LAND TITLE INSURANCE COMPANY ✓ u I al •"� PECONIC ABSTRACT f RICHARD A. BOKINZ ' ���� MARGARET BOKINZ LO © I >f'01! 1MYM OR BiOROOIia , VACANT 8I r 01 30.3 I S <b • r0".°p` ,ai, S 82'58 0.. E s �Ao �� 4.1'w ., 13 82 `.. 1 25.45• IP ..2.1Zi3 `r•kl 20.5 VAcW � I 1 NOTES. 1. ELEVATIONS ARE REFERENCED TO AN ASSUMED DATUM N ZTs�. o EXISTING ELEVATIONS ARE SHOWN THUS:20..11 48. • C/rt PROPOSED ELEVATIONS ARE SHOWN THUS: I12.01 • ` ,7gQ ryw°,o'sw T C - TOP or axle 31.2 u°4' B C - BOTTOM or CURB IP E. > 'B 2. LOT NUMBERS SHOWN THUS: LOT®REFER TO . cn:"" <� MINOR SUBDIVISION FOR JAMES MANOS � n o MAPPED JULY 1, 1981 AND AMMENED OCTOBER 5, 1981; 'I APRIL 29, 1982 & AUGUST 10, 1982; 31.59 ' -I�`• \J , A TR[E ^� 4. IF CLAY OR BOG IN THE LEACHING POOL AREA IS FOUND, R MUST SE• `` EXCAVATED AND REPLACED WITH CLEAN SAND.lf o N 83 26'00" ly 70 , m"c o Lis° PROPOSED EXPANSION POOL I 8 j $ PROPOSED LEACHING POOL ��v__ 111 /{ N CESSPOOL 0 riS WOODS �� I ® PROPOSED SEPTIC TANK ' `oa z _1.4 / fl^MIER 5. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD 04o J -7---- ' // OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS. y3a �' 6. REFER TO MINOR SUBDIVISION MAP FOR TEST HOLE DATA. C as MINOR SUBDIVISION APPROVED BY S.C.D.H.S. ON AUGUST.23, 1983. q r+ 1 - 7. S.C.D.H.S. REFERENCE No. R10-98-0075 yI--. E-., y '� 2<.0 kavit I ' ~ ' IL Q STANDARDS I FOR ACCORDANCE SU- •WITH AS ESTABLISHED O� LOT® � '10' C) BY . • .AND APPS; • AND ADOPTED \'"�- >? •�U H ..'^ THe r YORK STATE LAND s'..1-.,-3 • 2z21 0 mr 1?%\ ' � a 15.6 .3 * ',1 T i � _ �'r o 4 0 t ' A� 5 ariT.3V E Z j 14. 'I � `_ Ca+c ,.r yQ N Y.S Lic No..4966$ ���JJJ UNATHORIZED ALTERATION OR ADDMON yJ _ 2e�.°9• r°In+o_L4,b i b TO THIS SURVEY IS A VIOLATION OF , SECTION 7209 OF THE NEW YORK STATE NUN. COPIES EDUCATIONOLAW � A. O 25.6 o COPIES OF THIS SURVEY MAP NOT BEARING Ingegno N 83'11'30" H ^_ THE LAND SURVEYOR'S INKED SEAL OR "MLLE o-°arr a ti EMBOSSED SEAL SHALL NOT BE CONSIDERED � Surveyor r v e �� t - _ _ - - - (h'OLB R RIGHT TO BE A VAUD TRUE COPY y ROO OF it . 200.00' 32:01: "�D u p: °�+tno x mE) (PR�1'ATE CERTIFICATIONS TIONS INDICATED HEREON THESHALL S RUN ►SRti - 1tOAD) ONLY TO THE PERSON FOR WHOM THE SURVEY - 1: IS PREPARED. AND OH HIS BEHALF TO THE , DW ` _ - - - - _ TITLE COMPANY, GOVERNMENTAL AGENCY AND Title Surveys — Subdivisions — Site Plans — Construction Layout ELUNG to, Po E _ LENDING INSTITUTION USIED HEREON,AND (WELL TO THE ASSIGNEES OF THE LENDING INSTI- ♦ & CESSPOOL OVTUTION CERTIFICATIONS ARE NOT TRANSFERABLE ' ER 150') DWELLING PHONE (516)727-2090 Fax (516)722=5093 (WEU & CESSPOOL AVER1-50' DWELLING THE EXISTENCE OF RIGHT OF WAYS i 50') (WELL & AND/OR EASEMENTS OF RECORD, IF OFFICES LOCATED AT MAILING ADDRESS CESSPOOL OVER 15p) ANY. NOT SHOWN ARE NOT GUARANTEED. One Union Square P.O. pox 1931 Aquebogue, New York 11931 Rrverfieod, New York 11901 ...+,�- 9i= A 1