HomeMy WebLinkAboutFredericks, George J
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ELIZABETH A.NEVILLE
$4°‘0 �� � Town Hall, 53095 Main Road
TOWN CLERK jg
1111; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS t/� Southold, New York 11971
MARRIAGE OFFICER „. ► �1�' Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER _qlfl,� Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER COUH ,,8i�'ie 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. 3339 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : GENDOT HOMES
Fddress 1: PO BOX 534
City St Zip WADING RIVER NY 11792
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 #R10-04-0185
Name Of Owner FREDERICKS, GEORGE
Nailing Address 1 605 GROVE ROAD
City St Zip SOUTHOLD NY 11971
Property Address 1 605 GROVE ROAD
City St Zip SOUTHOLD NY 11971
lax Map No. section 74.00 block 2 lot 9.000
Cross Street MILL LANE
Building Permit Number Cross Reference:
Issue Date: 7/08/05 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
.I► .
'-t 0 SOa= 3331
ELIZABETH A.NEVILLE ,��O�� y�l
� O N Town Hall, 53095 Main Road
TOWN CLERK iii 4; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS It N Southold, New York 11971
%MARRIAGE OFFICER ���i Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER ���, A,.01 Telephone (631) 765-1800
FREEDOM OF INEDBMAFFICER COU southoldtown.northfork.net
_. --: . .; Nit q? 1 r0! ,
-!2�*' ----1
4 E U ` OFFICE OF THE TOWN CLERK
'AI . SUN 3 i� TOWN OF SOUTHOLD
' ', .J
r
I`TO ' � �Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: June 23, 2005
Transmitted herewith is a copy of application No. 3482 for a Cesspool/Septic Tank Construction
Permit submitted by:
Gendot Homes
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: �., �� _ —
714400".(42K HGc
Signature
Z 3 s--
ted
0004
61
ELIZABETH A.NEVILLE ��h`Z Gf.` Town Hall, 53095 Main Road
• TOWN CLERK 2 P.O. Box 1179
REGISTRAR OF VITAL STATISTICS "yj, �; Southold,New York 11971
MARRIAGE OFFICER
O •F �� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER y�0 AN` Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER - * ,,'' southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $10 V or Non-Residential @ $25 Application No. Si5)
44144.3
Permit No.
/^
Applicant Name ve n a1
Applicant Mailing Address lb 6o)( A-3 y
�JGr�lwj Auer /01 011
Septic Tank / or Cesspool V
Brief Description of Proposed Construction or Alteration ,1/1.) ,4 OT ye
Location of Proposed Construction/Alteration: \
S+
Owner of Property: 6e0�,� �
Owner Mailing Address: Eos ('rave !ed
$u '-lielci /4 1(9 7/
Owner Property Address: -k Pel e CL_' 604e
Name and phone number of contact person 414dOC d w
Tax Map No: Section 7y Block Z Lot q
Cross Street /OW Ga•
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEAL PARTMENT APPROVAL
X47 c-,z 3
Signature of Applicant Date
Received by:
fflf
LOT AREA = 29,232 SQ. FT. NOTE: NOT IN FLOOD ZONE - SEE PANELS 161 8 162 05-173
F.FL. EL. 16.0'
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U ,2 .-„„ TY"''
a
UCAVATIOV INSPECTION MOWED'
Q
° oQ TEST HOLE
?o.,.. / 10/22/2004 eoscience
ELEV. 9.4'
O Dark brown loam OL
Ni
02 v •^ ��r, ��b Brown clay CH
s�� / b.,,,,,;;0, (P.
�� ��y ��i�d 7.8'
qr. �o p�/\ ff �., '6)c
•6'� yo.�
yQ°� � Q�O >)(.D ./
) 0 ��• Wale-in brown clay CH
�y �\ CD O /^ / / \p/ t` I 20
a'. ` ,s /! �� c
O / 43 Al .
prop
/ well / Water in brown clayey sand
and sandy cloy SC aCL
/ / !
R0•W s�'b
elit
qrE
y o N
/ / Water in brown fine
1 � Cfit
"�• / 51' to coarse sand SW
1 nes{ 4,(o-O��Cp / O / \ ~
i . ,\ \/ U ki
/� / H-of O NOTE A
+'� A W Z elevation of water in pipe (6.6')
i ` elevation top of pipe (12,7')
~I108.µ / 4o¢`Qo' fI o elevation of grnd at pipe (10.2')
/ IV / z SEPTIC SYSTEM NOTES:
'11.1%.
,I S f z U 1-1200 gallon septic tank
i I //� `S* / \9. Q 6- 8 ft, dia., 2' high conc.leaching ri,,gs\c")
a°' s� d \W > (13.0) proposed elevation
1 . it
33• o\ Q�o��� 41;t4'
��\:!' 4 Fel Q Q
U7 ! I ��' \ i/•�o 3-
el
�; vi 2( �� \ Qe-C.
�--- 1,4411 W 1_1_1 ok. ' ..,.
O •'' ib* •.`Q 20 �e f pipe(2e�note wl _ eB;'
SO‘
o °f' , r�fPxl)
to
cn f ^�path O z rM' e I �`\ V
—1 <1 0 ''' '''''' ,.---------4.--.-„,1: \ \ / — .
U J w v / \o
s��1f \.. J fl`i V J
wN. \ :
'% Y
0 0 ;IS o Hedge o a g 4:
N. 24°42'50” W. 135.00'
acM CESSPOOL � I. '^
l' 0 11
ii "J• '` LOT NUMBER 48OMAP OF END of PA9. 61 1 �� '� O
- PECONIC HOMES - SECTION TWO
41 i ... 6 jak .
DWELLING - WELL i
C6IC
Os t0 i /1 'N't '11W, \ D
i. NOTE: LOCATION OF ADJOINERS WELLS, CESSPOOLS 1 v
AND SEPTIC TANKS BY OTHERS AND ARE NOT `�
GUARANTEED. N,. %
•
O 5-11-2005 TOPOGRAPHICAL SURVEY 8 REVISED SANITARY-SYSTEM
r J :w. 12-6-2004 REVISE LOCATION OF PROP. WELL 8 CESSPOOLS .
34'
0 vffSens NV IMPEMNit iiummokra wpm:Ants ••• JOB NO. 04-415 FILE NO.. 842 F
;OWN SEMI* •ROM THT >I411LIF RUM ONLY T4? 11 P 1
TRU4:TURU TO 'NE PRGoERT: FOR WHOM 1141! SU IY IS mi. SURVEYED FOR '
1' Nes Am POR A swam FUR PARED. AND ON 'R$ WULF TO
OSE AND USE ANO THEREFORE THE mu OOAIPANY.
I VIE NOT INTENDED TG GUIDE THE *Al AGENCY 4ND LINdIF11fU IS
SECTION OF FENCES QETAINING TUUON !ISTED HEREON AND K
W,U POOLS. PATIO! %ANTWG THE ASSIGNEE! OF THE LENDING
'AIMS. woomos IT bWtD'NGS INS?,.UT:ON GUARANTIES AM
is ARAwRStIROONSTRUCTION NOT TRANSIERAILE TO. AQCITIONP/ SITUATED AT PECONIC
•NsrWTrpNS LlP $UPIEUUINES
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1NAIPhi013EIsd �!TEIlAT,u« OP
ALIDTIIOP4 ' T4NE •URHEY rb
�t01AloN p TIEGTION >70� uF lit COPIES Of TIN: NW MM NQI TOWN OF SOUTHOLD - SUFFOLK COUNTY, NEW YORK
T STK7i EpfNJITIOIL OEA11NP THE (AND
34)SWYOR'E
v SCALE 1" = 40' DATE 10 - 12 - 2004
2 FILED MAP NO. - - DATE
GUARANTEED ONLY TO
u..r
TAX MAP NO. 1000 074 2 - 9 (REF. ONLY) DISK 247
HAROLD F. TRANCHON JR. P.C.
LAND SURVEYOR
,, - ,m..
--2 .
P.O. BOX 616
n 1866 WADING RIVER—MANOR RD. WADING RIVER,
14......,
NEW YORK, 11792
HAROLD F..TRANCHON JR. N.Y. LIC. NO. 048992 631 929-4695
PENN. LIC. NO. 21115-E
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