HomeMy WebLinkAboutGendot Associates Inc (2) •
'••
,I•0v‘ OFFO4co
ELIZABETH A. NEVILLE ���= % Town Hall, 53095 Main Road
TOWN CLERK ; o ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS
v, Southold, New York 11971
MARRIAGE OFFICER :�1i 1 ���, Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER ��! $jU°i� Telephone (631) 765-1800
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. 2819 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 #R10-02-0045
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)
•
,��,I.�o�1g11FF0��►CO'1/4 0207
ELIZABETH A. NEVILLE 0 �; Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS w' i Southold, New York 11971
MARRIAGE OFFICER Fax (631) 765-6145
� y � ��
RECORDS MANAGEMENT OFFICER �a�,,0 Telephone (631) 765-1800
FREEDOM OF INFORMATION.OFFICER �� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
6 'r';`, '' TOWN OF SOUTHOLD
TO: Southold'Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: April 25, 2002
Transmitted herewith is a copy of application No. 2911 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: '*✓ / "1'041QZ%
f(eise
Signature
p5r� oz
Dated
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18.0
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/yam/�/�p TOWN CLERK ,..I...... ..
• OflIMO IVRNCLERK
TOWN OF ROUEIIOLD
�ZAarmA.NBVIId.E.TOWN Application No.�� (I
P.O BOX 1179 Construction
SOUTHOLD,NEW YORK 11971 •
Alteration ��
Telephone $10.00 —ResIder<tial ✓f
(6311) 765-1800 - 1 I t i`;/ $25.00 -Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee •$
DATE 256Z
APPLICANT NAME: n J 55��A1u3 ��)C
APPLICANT ADDRESS: e0 ISct53 I- Aa I,, • v ,4.y_ 1171-2_
SEPTIC / CESS
POOL •
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DESCRIPTI N OF P OPOSEI CONSTRUCTION 9R A ERATION
GD S f oro4 On '� vn -
L ' ,of Com ,,h
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONST• UCT ,0 N OR {1LTERAT ON:
•
• . OWNER OF PROPERTY: � 5-s- Pt S CtYho 6-'17aA14 1
Coy
OWNER MAILING ADDRESS: I. i>. 53 �• \ �' P
►,r-� �y / 7 I Z
OWNER PROPERTY ADDRESS: •. ' . ` ► i 1 f 04) S.,>%411:)7t—
••••••••quy
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TELEPHONE NUMBER OF CONTACT PERSON: 6;3 I 9)91 LjQ"7—
TAX MAP NO.: Section / 0 Block 3 LotO p2 a
CROSS STREET: k`!al-.�✓1 1111Q,yN
BUILDING PERMIT NUMBER CROSS REFERENCE:
•
Signature a Appiica�nt
RECEIVED BY:
I'vown Clerk's-Office
DATE: • D,
ut Fa '
IIIPLAT AREA= 40,182 sq. ft.
F.F. ELEV.= 19.5
GAR. ELEV.= 18.0
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NM'RC e1 INI OF No. 01-617 ALE No. PECONIC DEV€L CORP.
MA RMs ARM ASMMRON TO M ALSO1R0 OR ANY COM oONRR1111ORErt.
SURVEYED FOR
LH Moate AMMON O11 A00M1oN m not Mu11Er M<A v1OIA11ON of a®ct1ON LOT NUMBER 6
MOO OP MR looms"VIII SORE Mo11s+o1oN M. MAP OF PECONIC DEVELOPMENT CORP. AT SOUTHOLD
awilmoss mama aMs11 oak ala wax m na P1MtDN FORM ON DE
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COP IF MR sir+w NIX,MANN TIt[LAND Illalt IR'i MED UAL OR SCALE 1- = 50' DATE 12-20-2001
0111000/OKOWL NOT EoO1M1OORDmMeAWM11 MN COPY.
FILED MAP No. DATE
CERTIFIED ONLY TO: TAX MAP No.(REF ONLY) 1 000-70-3--P/022 DISK 500
HAROLD F. TRANCHON JR. P.C.
LAND SURVEYOR
(-43—.14/ F T/-4--, a 1886 WADING RIVER—MANOR RD. WADING RIVER,
NEW YORK, 11792
NHAROLD F. TRANCHON JR. PE N. LLIIC. No.2115 E 631-929-4695