HomeMy WebLinkAboutKruk ,/� ®"%%i F0(4 tto
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ELIZABETH A.NEVILLE ,O a� * ; Town Hall, 53095 Main Road
TOWN CLERK o P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS i Southold, New York 11971
MARRIAGE OFFICER ,L °F �, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER \may"'/®1 ��®����, Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER �,,►'� southoldtown.northfork.net
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2944 R Residential x Non-Residential
Fee $ 10.00 Septic x Cesspool
PERMIT ISSUED TO:
Name : SCOTT KRUK
Address 1: 125 ALDRICH LANE
City St Zip LAUREL NY 11948
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 #R10-02-0186
Name Of Owner KRUK, SCOTT
Mailing Address 1 125 ALDRICH LANE
City St Zip LAUREL NY 11948
Property Address 1 49852 ROUTE 48
City St Zip SOUTHOLD NY 11971
Tax Map No. section 55.00 block 3 lot 4.006
Cross Street OLD NORTH ROAD
Building Permit Number Cross Reference:
Issue Date: 12/26/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
. d9 (-lc/
ELIZABETH A. NEVILLE �I���� D0#�, Town Hall, 53095 Main Road
TOWN CLERK y - P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ze
% i Southold, New York 11971
MARRIAGE OFFICER `` 4, �i�, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ----76:1 as Telephone(631) 765-1800
FREEDOM OF_INFORMATION OFFICER �� southoldtown.northfork.net
s;� NT/ 8 2007{ OFFICE OF THE TOWN CLERK
LW.-\___
TOWN OF SOUTHOLD
TO:T Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: November 15, 2002
Transmitted herewith is a copy of application No. 3064 for a Cesspool/Septic Tank Construction
Permit submitted by:
Scott F. Kruk
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: 11./ -- �
Signature . , .,�
Dated 3/2--
J
I-
OFFICE OF THE TOWN CLERK �,,,, ,,,,,,,,,,,:IT . /
ELIZABEOVVN NEWT SOUTHOLD
' � �J� OtI��+O Application No. ®(v�
P.O.BOX 1179 ' iO Construction
SOUTHOLD,NEW YORK 11971
• v
tri Alteration
Telephone ,� 0-,' $10.00 - Residential
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(G3]-) 765-1800 - #ol �a � ,�
-Non-Residential
Non-
Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE 1 ` ll5/C
APPLICANT NAME: SCG Kc. 1 C
APPLICANT ADDRESS: I aS 4\ CSV 1C h L
1--rtc •
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
57A/(,-c.E v'9 4/1 (C?' (- t ..//YG—
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTER TION: .
OWNER OF PROPERTY: Stp4A—P '
OWNER MAILING ADDRESS: 1-D. b A-) (V'v h 1._01
L -e t c yv-P 1 N! I l c LL-g
OWNER PROPERTY ADDRESS: - - C LO
cc.ny-O LJ
TELEPHONE NUMBER OF CONTACT PERSON: AO. - 7 , 1�-� (-1_,6o.�7GC)
TAX MAP NO. : Section �j Block 0 Lot d 9I 4f3
CROSS STREET: U/'c( ,1J £(
BUILDING PERMIT NUMBER CROSS REFERENCE:
V
Signature of Applicant
RECEIVED BY:
Town Cle k's
DATE: 1/ - DC7 --- 0 � .
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TEST HOLE DATA
(TEST HOLE DUG BY McDONALD GEOSCIENGE ON SEPTEMBER 6, 2002)
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DARK BROWN SILTY LOAM OL
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! •• PALE BROWN SILT ML O
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PALE BROWN SILTY SAND SM �� /�'
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:i 04-,. .).-4e-. '•
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;:: a PALE BROWN MEDIUM :(PI '
BROWN SAND SW 4
TO COARSE * }
~.-yw'` r.:.=--13.6' 1rC
WATER IN PALE BROWN MEDIUM / ,1,4;TO COARSE SAND SW Grp''
43
17'
•
OLD NORTH ROAD
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rUPFOLIC COUNTY DEPARTMENT OF HEALTH SERVICES
PM=YOR APPROVAL OP CONSTRUCTION FOR A '3&i?%(41, -f--c(Pkp
l®INCLE FAMILY RESIDENCS on?
)leu t l-i Li -62- Eis F.tie.PI i --01, '''C r,,‘
MOVED�,� /
FOR MAXIMUM OF : • MS
o
EY1VRES THREE YEARS PROM DATE OP APPROVALtic5.
- PREPARED IN ACCORDANCE WITH THE MINIMUM
STANDARDS FOR TITLE SURVEYS AS ESTABLISHED
BY THE L I.A.LS. AND APPROVED AND ADOPTED
FOR SUCH USE BY THE NEW YORK SPATE LAND
TITLE ASSOCIATION.
, ,it i i ,
,4,sA .71y ' N.Y.S. Lic. No. 49668
.1-ANTI- UNAUTHORIZED ALTERATION OR ADDITION
TO THIS SURVEY IS A VIOLATION OF
SECTION 7209 OF THE NEW YORK STATE
Josep A. IngegriO EDUCATION LAW.
COPIES
FTHIS RSN
eIKED NOT SEAL OF-RRRING
THELANDSURVEYOR
Lan . Surveyor TO BEEDVASEAL SL NOT UD TRUE COPY. BE CONSIDERED
CERTIFICATIONS INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY
IS PREPARED, AND ON HIS BEHALF TO THE
TILE COMPANY, GOVERNMENTAL AGENCY AND
Title Surveys — Subdivisions'— Site Plans — Construction Layout LENDING INSTITURON LISTED AND
TO THE ASSIGNEES OF THE LENDING,INSTI-
RHONE (631)727-2090
Fax (631)727-1727 TUIION. CERTIFICATIONS ARE NOT TRANSFERABLE.
OFFICES LOCATED AT MAILING ADDRESS THE EXISTENCE OF RIGHTS OF WAY
1380 ROANOKE AVENUE P.O. Box 1931 AND/OR EASEMENTS OF RECORD, IF i' ,
oI\,cpI.lFAfl New York 11901 Riverhead, New York 11901-0965 ANY, NOT SHOWN ARE NOT GUARANTEED.
SURVEY OF PROPERTY ti, ,
/ SITUATED AT 1
SOUTHOLD
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-55-03-4. 6
�
� 1000-55-03— P/0 4.3
�� SCALE 1 "=50'
���•�� JANUARY 21, 2 DECEMBER, S OWW'BOUNDDARRY,LIME A EESPrtlr�1T
AUGUST 21, 2002 ADDED PROPOSED I-1f k.S,E ,-� .-n
4 t4y4}%- } f.- yy+
'�%tg\ gasAREA = 97,827.11 sq. ft. `,a=, ' %rc'a,
2.246 ac. "�\': "``s ,
.;4, ,
° \ *>. r
4 Te.
` , NOTES:
1. ELEVATIONS ARE REFERENCED TO AN ASSUMED DATUM
4 EXISTING ELEVATIONS ARE SHOWN THUS:50 0
? 2. MINIMUM SEPTIC TANK CAPACITIES FOR A 1 TO 4 BEDROOM HOUSE IS 1,000 GALLONS.
�`f \ 1 TANK; 8' LONG, 4'-3" WIDE, 6'-7" DEEP
*el, . 4;4, 3. MINIMUM LEACHING SYSTEM FOR A 1 TO 4 BEDROOM HOUSE IS 300 sq ft SIDEWALL AREA.
sTq ' 2 POOLS; 6' DEEP, 8' dia.
't:bs\ . PROPOSED EXPANSION POOL
\ U% PROPOSED LEACHING POOL
® PROPOSED SEPTIC TANK
4. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD
•
3 N. <'4 OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS.
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TEST HOLE
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CERTIFIED TO: , '
SCOTT KRUK
BANK OF SMITHTOWN
COMMONWEALTH LAND TITLE INSURANCE COMPANY
` 21-61