HomeMy WebLinkAboutGendot Associates r lel,'. FFOL -
ELIZABETH A. NEVILLE '�ti� t% : Town Hall, 53095 Main Road
TOWN CLERK ti P.O. Box 1179
REGISTRAR OF VITAL STATISTICSr �t Southold, New York 11971
MARRIAGE OFFICER i ovie. Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER %=__-7 #ses. Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER 1 j'- ill~ ''isr
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2428 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : GENDOT ASSOCIATES INC
Address 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 #R10-00-0156
Name Of Owner GENDOT ASSOCIATES
Mailing Address 1 PO BOX 534
City St Zip WADING RIVER NY 11792
Property Address 1 70 ZENA ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 106.00 block 5 lot 25.000
Cross Street RUTH ROAD
Building Permit Number Cross Reference:
Issue Date: 10/13/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
po
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ELIZABETH A. NEVILLE ��= Gtkt: Town Hall, 53095 Main Road
TOWN CLERK H Z P.O. Box 1179
REGISTRAR OF VITAL STATISTICS 1.30 Pr7 $ Southold, New York 11971
MARRIAGE OFFICER .f� � �1� Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER __�e! .1,•1:0'• Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER °°1
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: October 10, 2000
Transmitted herewith is a copy of application No. 3518 for a Cesspool/Septic Tank Construction
Permit submitted by:
Gendot Associates,Inc.
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:
Si ature
ie/t . / U �)
Dated
le r. MAY 11 •'_+;, , :.IFT_'F SOUTHOLD TOW 1-{ALL n10 76L7 1
P. 1
OFFICE OF THE TOWN£ER)n •o.``'r�� OLet �rrfff"�_=+
TOWN OF SOUTHOLD Application No.
euri mm ,ti.Kraus.YAWN ri ARK ' - -
P.O.BOX 1179 },,,8# Constritrtinn y/
SOUTHOLD,NEW YORK 1197. ia •,'.�, 1
0 �/ Alteration,____
Telephone ,^--1-0•44 •:* $10.00 - Residential
P
(516) 765-1801 -.41 o%;,,►' $25.00 - Non-Residential
•
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. '
Fee '$ ____�
DATE 1() /5' 42c)
��
APPLICANT NAME: 61_404 A'5'`'(: ).-e3 '1'64 ' . ' •
• APPLICANT ADDRESS:Pax 53 Vp)i'e ig,\Avt. .! .L1'9 -
_ ____
_ . .___
SEPTIC (CESSPOOL-1
DESCRI TIQN 0I PROPOSED CONSTRUCTION OR <ERATION _
•
i ro 0 , ,___9(33
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LOCATION MAP: Must be attached hereto before permit may be issued,
LOCATIONOWNER,OF OPPROPOSED PRt7PERYvCC7N �RVCTtRP0� A�,.��J�Tft�Ni . .
--
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS; 1O Viu1 Ad .-171-7117-10 pt/ --
TELEPHONE NUMBER OF CONTACT PERSON: 12 I'9Z_'tpI ,
TAX MAP NO. : Secti 0 _Block_ JC` Lot a 5 �___ _.__�
CROSS STREET: v' ���_ - — —
BUILDING PERMIT NUMBER CROSS REFEREN —
Signature of Applicant--7—
.
RECE1Vr` : c i ; •
—Town Clerk's Office-
DATE•
y ,
JOB No. 00-32 • TAX I.D. No. 1000-106-05-25
• TEST HOLE
5/30/00
1 OL LOAM
SM LOAMY SAND
3'
TAX LOT 15
SP FINE SAND OCC RES PW
TAX LOT 14
8, 1 OCC RES
WELL FRONT YARD
•
SILTY SAND , CAPTAIN KIDD DR.
SM TAX LOT 24
OCC RES PW
14' 4SP FINE SAND N 77°26'00"E 111.37'
WOOD SHED
20'
102.5 0.3 S u
0.7 S10, 106.1
TEST 101.6
HOLE
X DRIVEWAY cV
•occ LOT RES23 PW IN PROPOSED o
Z WATER SERVICE rn
Z
D N _ . SINGLE w
35' `� p
O 6 FAMILY a,
OC M
< 0)
co
0 0) 57 FF 104.0 15'
TAX LOT 22.3 0 GAR 102.5 TAX LOT 26
OCC RES PW ► "' p OCC RES PW
SEPTIC
11111
,—, 35' Q O
99.7
...)
102.2
R=25.00'
L=39.27' S 77°26'00"W 81.79' TAX LOT 37 --+-
OCC RES PW
-1
SUFFOLK COUNTY DEPART cvC NT OF HEALTH SERVICES
99.7
100.5
PE2MFr FOR AP A3 Y:V .O CON3TRUCT7S7i rota.A RUTH ROAD [ 50' ]
(� SINGLr+.y'A,MY L,Y;cEv:T i ITC ,ONLY
'BATF. ! {'[-co i.fS ...F. trALAii,a. IU ..Q • - a (,
APPROVED _ `j',
Aima -
FOR MAX F ,EER. ti MS ThX.WT i5.
TAX LOT 14 OQC ES PW
EXPIRES THREE YEARS FROKparpgF APPROVAL OCC RES PW -_
EXCAVATION INSPECTION'REQUIRED --
FOR SANITARY SYSTEM
BY HEALTH DEPARThNT
ELEV IN ASSUMED DATUM FILE MAP Ns;1674'', 1/19140
Unauthorized alteration or addition to this document is a violation of Section 7209
of the New York State Education Law. SURVEY OF: LOT 179
Certifications Indicated hereat shall run only to the person for whom It is prepared
and on his setoffer the Title Company, neva of Agency and Lending MAP 0 F C A PTA I N KIDD E S TATE S
Institution listed Mason,and to the entrees of the lending institutions or
subsequent owners.
Copies of this document not bearing the professional's inked seal or embossed MATT I TU C K, TOWN OF SOUTH O L D
seal shall not be considered a valid true Dopy.
The offsets[or dimensions]shown hereon from structures to the property lines are
fora specific purpose and use and therefore are not intended to guide the erection of SUFFOLK COUNTY, NEW YORK
fences,retaining walls,pools,planting areas,addition to buildings or any other
construction.
The existence of right of ways and/or easements of record,if any,not shown are SURVEY DATE: 6/6/00 SCALE: 1"=360'
not guaranteed.
CERTIFIED ONLY TO: �, "--4ilia,,.
GENDOT HOMES kv'�i,9- O.6 DESTIN G.GRAF
- �Dzsi ,,-. GRAF yr- LAND SURVEYOR
,,
t i wi •
h—Ir ; .•. °rn i 73 Woodlawn Road
.4;.,..
0""--
'-- ', RockyPoint, N.Y. 11778
By DESTIN G.GRAF N.Y.S. LIC No. 50067 rn ++ 0 ODf]7 - � 516-821-3442
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