HomeMy WebLinkAboutAndonison, Edna dI o$FFOL f'
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ELIZABETH A. NEVILLE e_ �: Town Hall, 53095 Main Road
TOWN CLERK o P.O. Box 1179
Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER N...4''/' "i. • Fax(631) 765 6145
RECORDS MANAGEMENT OFFICER Q1 a0 0° Telephone (631) 765 1800
FREEDOM OF INFORMATION OFFICER ��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2252 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 #R10-99-0246
Name Of Owner ANDONISON, EDNA & SCHILLING, A
Mailing Address 1 PO BOX 2845
City St Zip NORTH WATERFORD MA 0000
Property Address 1 730 WABASSO STREET
City St Zip SOUTHOLD NY 11971
Tax Map No. section 78.00 block 3 lot 49.000
Cross Street HIAWATHA'S PATH
Building Permit Number Cross Reference:
Issue Date: 3/01/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
.„
ELIZABETH A.
N:`dILLE G
IZy�% Town Hall, 53095 Main Road
TOWN CLERK FEB 2 4 2000 �; r P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER if. � �� Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER �Ql �a�iii Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER is.
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: February 24, 2000
Transmitted herewith is a copy of application No. 2341 for a Cesspool/
Septic Tank Construction Permit submitted by:
Gendot Associates •
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.
Thank you.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following re mendations:
APPROVE
DISAPPROVE
Comments:
ignatur
9-bir-76 6
Dated
OFFICE MIRE TOWN CLERK ," �`1 BIKD
- ;3C4 (
IT
,.:TOWN OFSOI'HOLD �J Application No.
ELIZABETH A.NEVILLE,TOWN CLERK
P.O.BOX 1179 Construction
SOUTHOLD,NEW YORK 11971
Alteration
Telephone
$10.00 - Residential
(516) 765-1801 - 1 ��' $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 al2Li\bo
APPLICANT NAME: Cy-WC)011 ':6 �C-
APPLICANT ADDRESS: X S 3 fid1f 1 t'vV, , N-J,
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION St,►.) CbCdl,
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATIONOF PROPOSED C
UCP�t Al
OR AL l
OWNEROFPROPERTY: d�4i l ElimtrA..561,111,
IlkisLAc
1�5
OWNER MAILING ADDRESS:Z1C a$ iS DSI. 1^1A6C-LJ �N ,
OWNER PROPERTY ADDRESS:-730 44,0bAS‘a
TELEPHONE NUMBER OF CONTACT PERSON: (, i -e2°l- G 9C 7
TAX MAP NO. : Section 1 lock 3 Lot 149
CROSS STREET: 44AWirIVV4P k)/a'1
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applica t
RECEIVED BY:
Town Clerk's Office
DATE: a a l,( o o
SCDHS Rel.# R/0-99-0246 w`///erg"
uM:n.re A The locations o/woes and cesspools
shown hereon ore from field observations
and or from do/a obtained from others. ...- (-1 s
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AND CONSTRUCTION OF SUBSURFACE SEWAGE O ) • Mem
DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES (M^PE s/e .
and wY abide by the cond/Ions set forlh Ihereln and on Phe (%,,a-r".)
permit to construct. Ir
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(B..,p.P el.vmhe^
SURVEY OF PROPERTY
-.— AT SOUTHOLD
TOWN OF SOUTHOLD
SUFFOLK COUNTY,N.Y.
1000 - 78 - 03 - 49
sEnmxCOUNTY DEPARTMENT OFMALTASERVICES SCALE 1". 30'
PEWIT POR APPROVAL OFCONS.RuCTIONraft A NOV 1999
NOV.150999/CerldkadoR added)
SINGLE FAMILY RESIDENCY ONLY
R l� NOV.22,1999(pop.hoe. 1
DATE 1-I 2-00 HS'7'NO. -O�`}Gj Dec at-,rpi/rev s^�+s.o"*�)
�
APPROVED J.,... 4,2sovy ev.s,-v,
..14,,,
CERTAFIEO TO*
..14,,, t.00 TTTT<, . $)
POR MAXIMUM M Oi_�,BIS IIOMS
i KENNETH M.BURNS
OPUS YEARS FROM DATE OP APPROVAL LISA A.BURNS
COMMONWEALTH LAND TITLE INSURANCE COMPANY
1
i
ANY ALTERt OR AMMON ON ro no RAMEY IS A VIQU nON S,',t PDOF - .
=ETAS/TET R*cm moo-TOOK staomso EDUCATION cAnav a „.0,...0ra`y�
/NECK ARE YAW FOR TNS MAP Alp COMES n6EQ•OILY F
. SAD MAP QR COMES WEAR TEE STRESSED SEAL of nE SLRVEYOR I:� '"�T•. S.LK.NO.49618
MOM SVNATI.RE APPEARS HEREON, ':Ia ,';4.',..... .�
Al✓Fe r TO COMPLY MON SAD LAW TIE TERM ALTERED el" -•C
ME MY ANY ARD ALL SCRYEYQRS @@pp A CaY (�'" ::'( ,.f`,bQ
W' THEN AeREYOR's MAP TERMS SUCH AS W **-AID P.
,4)_•,--!i MO .T�
If-TO-DATE•ARE NOT M COSTUMES MTM THE LAE 12 �`✓, �` !l9REET
. AREA = 14,227 s¢ft SOU 4'
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