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Home My WebLink AboutDzenkowski SC JTFCLD VIASTEVIATER D SPOSAL PEF M T CPERATI CN PERM T SEPTI C TANG or CESSPOCL Oper at i on Per ni t W. 4469-R Resi dent i al X Wn-Pesi dent i al Fee $ 10. 00 New X Exi st i ng Narre Cf Domer ANDUN& J ESSI CA I ZENKOtM ------------------------------ Nbi I i ng Address 1 332 VVG13 NS STREET ------------------------------ Nbi I i ng Addr ess 2 ------------------------------ City ----------------------------- City St Z p EN'CRT W 11944-0000 -------------------- -- ---------- Pr oper t y Addr ess 1 1050 SCJTI-ERN BLVD ------------------------------ Property ----------------------------- Property Address 2 ------------------------------ City ----------------------------- Cty St Zip EAST NM CN W 11939-0000 -------------------- -- ---------- Ouuier Telephone W. 631-445-5405 Tax Nbp W. sect i on 22. 00 block 1 1 of 14. 000 ------ --- ------ Cross St r eet CEDAR DRI VE ------------------------------ ---------------------------------- I ssue Date: 5/ 14/ 14 EI i zabet h A. Nevi I I e -------- Sout hold Tom 0 erk (TOVIN SEAL) ELIZABETH A.NEVILLE 0 y� Town Hall, 53095 Main Road TOWN CLERK ti Z P.O. Box 1179 REGISTRAR,OF VITAL STATISTICS O Southold, New York 11971 RECORMARRIAGE S MANAGEMENT OFFICER y�0' `1►aOl� TelephoFax ne 163 6576541800 #ic p FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION OPERATION PERMIT CESSPOOL or SEPTIC TANK Residential @ $10 `C or Non-Residential @ $25 Application No. • r -I 0 / ` Permit No. 115 1� Owner Name e �nA CP A.A) �- c`��1 1 Y(`1� C�J�lu Owner Mailing Address 3314 Owner Property Address 0 JO -}(arn UP�l 6:0_26- Uawn Owner Telephone No. (031- L(l(S- k{b S S' 14 Tax Map No: .100 0 Section_ Block ( Lot L( Cross Street Cfa 'Cr I 1 VE- - i Please check each that applies: New Construction >Y Alteration to Existing System Residential. e —Non-Residential NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. (Locate building and system; give north arrow and approximate distance in feet from system to building and closest road. New construction may submit copy of survey with SCHD approval.) S 31 ature of Appli t Date GReceived by: Q��gUFFO(,�co ELIZABETH A.NEVILLE,MMC �� r/y Town Hall,53095 Main Road TOWN CLERKo P.O.Box 1179 CA = Southold,New York 11971 REGISTRAR,OF VITAL STATISTICS O Fax(631)765-6145 MARRIAGE OFFICER 'l'� Q�' Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER �.� `�►a www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SCLRHCLD V1pSTEVfATER D SPC6AL PERM T CGZTRUCTI CN CR ALTERATI CN PERM T SEPTI C TANG or CESSPCCL Per ni t W. 4168 R Pesi dent i al X Non-Resi dent i al Fee $ 10. 00 Sept i c X Cesspool PERM T I SSLED Ta Name : M3;EW& J ESSI CA CIZETKCJ'SI4 Address 1: 332 VVO3 NS STREET City St Zip G9934KW NY 11944 Descr i pt on of Proposed Construction or Alteration SAN TARP SYSTEM FCR SI NG.E FAM LY D'ELLI M APPRDA D AS STEM TTED AND AS APPRDM BY THE SLFFCLK CaNTY CEPARTIVENT CF HEALTH SEW CES. FI NAL APPFO/AL RECU RED FROM THF SLFFCLK CCLNN HEALTH DEPAIRTNENT. REF #R10- 13-0043 Wre Cf Omer ANDREW& J ESSI CA C1zETKC1(M ------------------------------ Mai I i ng Address 1 332 VV03 NMS STF ------------------------------ ------------------------------ Ci t y St Zip CPEE PCRT NY 11944 -------------------- -- ---------- Property Address 1 1050 SCUTHCERN BLVD ------------------------------ ------------------------------ Ci t y St Zip EAST MR CN W 11939 -------------------- -- ---------- Tax Map No. sect i on 22. 00 block ock 1 1 of 4. 000 Cross St r eet CEDAR OR VE ------------------------------ Bui I di ng Per ni t N.in�ber Or oss Ref er ence: �`.eQQY --------- Issue Date: 1/02/ 14 D i zabet h A Nevi I I e -------- Sout hol d Town Ci erk 1 r r 5URVEY OF LOT 13 N A5 SHOWN ON WW OF ACIUAVIEW PARK FILED JULY 30.1971 AS MAP NUMBER 5621 W E 51TUATE: EAST MARION TOWN: 50UTHOLD SUFFOLK COUNTY, NY S II 5URVEYLD 06-10-2013 vLOT 7 j 5UFFOLK COUNTY TAX► 1000-22- I-14 CERTIFIED TO: 96 a ANDREW W DZENROWSRI 5pIJTHL7W BOULEVARD n-sr JESSICA KARIE DZENROWSHI n-36 wsnutrPMMMee <^ 0 10 ---------, _ t149I AGE SYSTEM CALCULATION5: ' AREA=1493 50.FT. 7-- - raoroceo W Irn Iz 1 50.FT.X 0.17=253 fie i nb42.2—6 VERTICAL FT.OF 8'DIA.LEACHING POO.REQUIRED ® b DE(2)8'DW.X 3'5TORM DRAIN FOOL5 Q _ c 0 Is ° NAGE 5Y5TEM CALCULATIONS: _ cn C0 `-- _------ t m AREA=1687 SQ.FT. Z ----__--FT.X 0.17=286.7942.2=6.79 VERTICAL FT.OF 8'DIA.LEACHING POOL REQUIRED 1)8'D[A.X 3'4(1)8'X 4'5TORM DRAIN POOL5 .`•, NOTE:LOT5 5HOWN A5 THUS LOT le A5 5HOWN ON'MAP OF HIGHFOINT AT EAST MARION' N88°1 6'2O1N s3 FILED JANUARY 1 1. 1984 FILE NO.7680 195.72' t MCDONALD GE05CIENCE EL-39e ,E TEST HOLE DATA DARK BROWN LOAM OL 0MC14] I' we:sernc Iso,nroM emavoto ant Lor I PALE BROWN 5ANDY 51LT ML -----------7' vrtt�twrt � LOT 3 BROWN5ANDY5ILT 5M 0Mt1P� weu+ ----- ---2 / 0' NDie:3RfIC I'30i 1ROlA f100N9®MLLL j1 1 BROWN FINE TO C.OAR5E 5AND 5W ---28' COMMENTS:NO WATER ENCOUNTERED _ NOTES: ar. rrM • MONLIMIENT FOUND JOi1 N C. Eh LERS LAND SURVEYOR r.s. Area r 32.844 5q.Ft. Area .0.7539 Acres 6 EAST MAIN STREET N.Y.5.UC.NO.50202 !rte RIVERHEPID,N.Y. I 1901 369-8288 Eau 369-8287 IonglslandLvWsurveyor.com rL 11 I r I 5URVEY OF LOT 13 ' N A5 5HOWN ON'MAP OF AQUAVIEW PARK" FILED JULY 30,1971 A5 MAP NUMBER 5621 W E 51TUATE: EAST MARION TOWN: 50UTHOLD SUFFOLK COUNTY, NY 'L18R10 S 5URVEYED 06-10-2013 �r6 �LCq 7r SUFFOLK COUNTY TAX M w�[wuc +wcu 1000-22- I -14 CERTIFIED TO: o ANDREW W DZENKOWSKIP SOUTHERN BOULEVARD JESSICA MARIE DZENKOWSKI EL-39 IA�"`W L-3eY: 586'49'20V✓ I 6.46' EL-3 TE5T ol CD 4o 1u, .,y O aa(� LO ':fie 0 0 6 J '• �0 --------- DRAINAGE ------RAINAGE 5Y5TEM CALCULATION5: ROOF AREA=1493 50.FT. ----�.- - 12 1491 SQ.FT.X 0.17=253 Lor 1a 3 ILS'"amu_....._ "W e�s'W. � 0 wrcw� 253/42.2=6 VERTICAL FT.OF 8'DIA.LEACHING POOL REQUIRED PROVIDE(2)V DIA.X 3'STORM DRAIN POOLS O O WT 13 - - Cn RAINAGE SYSTEM CALCULATIONS: u )PJVEWAY AREA=1687 50.FT. .__BDILDIyri eVlr,,FE......... _ O �'r1 1493 50.FT.X 0.17=286.79 Z -- ------- s.T. - 286.79/42.2=6.79 CAL FT.OF DIA.LEACHING POOL REQUIRED PROVIDE(U 8'DIA. VERTI8'X 3'4(1)8'X 4'STORM DRAIN FOOL5 I` `•;�o d �NOTE:LOTS 5HOWN A5 THUS LOT d -3 FROFo9ED w[u SHOWN ON'MAP OF HIGHPOINT AT EA5T MARION" N88°16'20"W 195 72'D JANUARY 1 1, 1984 FILE NO.7680 McDONALD GEOSCIENCE EL=39' TEST HOLE DATA DARK BROWN LOAM OL DMRLL11D wEut uoTes[rnc 1 sD+rgorn rRDa7.ED vfu Lor� PALE BROWN SANDY SILT ML -----------7' oK ur \ O 3 \ BROWN SANDY SILT SM oxfulr�D /j wEu+ -----------20' / NTE:5—C 150+FROM PRDFO`iED N2LL \ BROWN FINE TO COARSE SAND SW ---28' COMMENTS:NO WATER ENCOUNTERED NOTES: .`a.r�wL ® MONUMENT FOUND JOt iN C. EIILERS LAND SURVEYOR - Area =32,844 5.1.Ft. w bt�w.11Y..w� M Area =0.7539 Acres .,,,.M r.=l Zr 6 EAST MAIN STREET N.Y.S.LIC. NO.50202 •+.A+« +��+ GRAPhIC SCALE I..= 60' "~""`�`� W H��W r. .✓r r• RIVERHEAD,N.Y. I I90I 369-8288 Fax 369-8287 '. longl5landland5urveyor.com i