HomeMy WebLinkAboutGendot Associates Inc •
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ELIZABETH A. NEVILLE �� _ y�; Town Hall, 53095 Main Road
TOWN CLERK o - P.O. Box 1179
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Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
'F � Fax(631) 765-6145
MARRIAGE OFFICER �- •f• �
RECORDS MANAGEMENT OFFICER =__*O,j $$��� Telephone (631) 765-1800
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FREEDOM OF INFORMATION OFFICER •••� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 2818 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 #R10-02-0046
Name Of Owner GENDOT ASSOCIATES INC
Mailing Address 1 PO BOX 534
City St Zip WADING RIVER NY 11792
Property Address 1 WELLS ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 70.00 block 3 lot 22.000
Cross Street OAKLAWN AVENUE
Building Permit Number Cross Reference:
Issue Date: 6/21/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE �� h� y ; Town Hall, 53095 Main Road
TOWN CLERK % o � % P.O. Box 1179
CI) Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER �,4 Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER x__-701 ��) Fax
(631) 765-1800
FREEDOM OF INFORMATION OFFICER �� � southoldtown.northfork.net
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OFFICE OF THE TOWN CLERK
6 2002 TOWN OF SOUTHOLD
TO: _..___' Southold Town ilding Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: April 25, 2002
Transmitted herewith is a copy of application No. 2910 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:
Signature ✓
O 5/02—
Dated
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Dated
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SOUTHOLD CLERK
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OMB OF TM TOwN CURAX
TOWNMBOMOU) ffOtK
A.ttB�' .ToviNet.auc - Application No
PA.BOX 1179 ,
4.D,NEa►YORK11971 Construction
Alterations
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Telephone `= *'�;'. • $10.00 -Residential V
(63t) 765-1800 = � �' -•-•- _
._ � $25.00 -Non-Residential
TOWN OF SOUTHOLD
•
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee •$
DATE L as 0z.
APPLICANT NAME: 'A b-I 1550c1161“--1',76.-
APPLICANT
ADDRESS: r O 6b4 3 Li .4) 1V-til- 6\14 1 •
SEPTIC J CESS POO L
DESCRIPTI N OF -ROPOS D CONSTRUCTION 4R ALTERATI N
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTR N•:
C ION OR ALTERATIO
• . OWNER OF PROPERTY: en)of �S s�.14(.5-?
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OWNER MAILING ADDRESS: 1'n
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OWNER PROPERTY ADDRESS: 041$ A ' 5 �, IJ •
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TELEPHONE NUMBER OF CONTACT PERSON: G3I-92q- CYO 7
TAX MAP NO.: Sectio ? 0 Block_ 1p—Lot ° Z
CROSS STREET: kj4�J✓) Ad C- `
BUILDING PERMIT NUMBER CROSS REFERENCE:
Ignature o Applicant
RECEIVED BY: 0 /I
own Clerk's 'jce
DATE: (jam
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THE OFFSETS (OR OIEMBCNS) SHOWN HEREON PROM THE STRUCTURES 10 THE
PROPORY UNE ARE POR A SP®Ri1C PURPOSE AMC Use AND THIDIVORE ARE Nat JOB No. 01-617 FILE No. PECONIC DEVEL. CORP.
W SURE THE ERECTION OF FENCES RET NNIO VOLLS. POOLS. PATIOS.
PURISM MM.ISOMON 10 BULOMSS OR ANY OBER CONERaJmwN. SURVEYED FOR
UNWTH ORS®AUSRISION OR A00010N 10 THIS SURVEY IS A VIOLATION OF SECT= LOT NUMBER 8
72011 OF TME MEW YORK SIAL EDUCATION US. MAP OF PECONIC DEVELOPMENT CORP. AT SOUTHOLD
Guayana w 10ATEa MOM/144N1 RUN ONLY TO THE PERNON FOR WHOM THE SITUATED AT SOUTHOLD
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MODS SIBFRRLnRN, SUNIVITRES ME NOT TIONOWE SLE 10 AOOMONN.SISRMTONs TOWN OF SOUTHOLD – SUFFOLK COUNTY N.Y.
OR SURIS DENT DINERS.
OOP OF THIS SAW MIP NOT BE NO THE L/MC SURVEYOR'S MSEC SEAL OR
SCALE 1" = 50' DATE 12-202001
oNDOs:ED SEAL sou-NOT BE COMSCEREO TO SE A VAUD TRUE COPY' FILED MAP No. DATE
CERTIFIED ONLY TO: TAX MAP No. (REF ONLY) 1000-70-3–P/022 DISK 500
HAROLD F. TRANCHON JR. P.C.
LAND SURVEYOR
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. _ 1866 WADING RIVER—MANOR RD. WADING RIVER,
�J°" ` NEW YORK, 11792
N.Y. LIC. No. 048992 631-929-4695
HAROLD F. TRANCHON JR. PENN. LIC. No. 2115–E