HomeMy WebLinkAboutGendot (4) ®SUFE®u '
ELIZABETH A.NEVILLE `����� : ,� Town Hall, 53095 Main Road
TOWN CLERK ® P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS "V 1
MARRIAGE OFFICER ` sfo %= Fax Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER l 11®'.6 Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER Zs" 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. 2954 R Residential X Non-Residential
Fee $ 10.00 septic X Cesspool
PERMIT ISSUED TO:
Name : GENDOT HOMES
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 HOMES
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 7ERNICK LANE
Building Permit Number Cross Reference:
Issue Date: 12/26/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A.NEVILLE ;,•'•. ®�el% Town Hall, 53095 Main Road
TOWN CLERK o ik P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS v' rrt i Southold, New York 11971
MARRIAGE OFFICER `=®,1,_ �����, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER = "'/®laik ��®iii Telephone (631) 765-1800
FREEDOM OF INFORMATION OF ICER ���,,�'� southoldtown.northfork.net
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FR 1" Linda J. Cooper, Southold Town Clerk's Office
DATED: December 2, 2002
Transmitted herewith is a copy of application No. 3076 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 loca ' n map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments: "`z`‘—'a12--1.r.-4--F1-v---"-: -,-,-Z Ar
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27,4-.4-. .
Signature
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Dated
OFFICE OF THE TOWN CLERK •d,•••iII,I,,•..
TOWN OF SOUTHOLD ,••.O��FFO��`►Ol/ Application NO. ������ '�J((,�.,,
ELIZABETH A.NEVILLE,TOWN rIFRK '� `7&
P.OBOX1179 ��
• � , Construction
SOUTHOLD,NEW YORK 11971 t
C=3 Alteration
6 Telephone ; �0 Q �• $10.00 - Residential ✓
( 3t) 765-1800 .1t ••
•• • $25.00 -Non-Residential
TOWN OF SOUTHOLb
•
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION •
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE ///2-74v
APPLICANT NAME:
APPLICANT ADDRESS: �� A,A!
I4& ,44/eP-- /It(
SEPTIC W CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
L2c �tp
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ,ALTERATION:
OWNER OF PROPERTY: A711/2611 _
OWNER MAILING ADDRESS: /4) 10.. .,..573'
�,' ,;1%iss f'(/r.-7 ,/(/ ' //"?92—
OWNER PROPERTY ADDRESS: 1-071- --41- e?
TELEPHONE NUMBER OF CONTACT PERSON: 61/— 42.2c1-6c/07
TAX MAP NO. : Section 70 Block 3 Lot f et6 2 2
CROSS STREET: gi,7,27/Gt
BUILDING PERMIT NUMBER CROSS REFERENCE:
Si01./?
g ture of Applicant
RECEIVED BY :
o n Clerk's Office •
DATE: t a1 oZClZ� __..r_, 1 -
I,
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�► 474.11 NOW OR FORMERLY
20' 44, 9„W 69..9 JAMES H. RICH JR. — VACANT
(16.8) S 81'40'00"W 86.20' S 70�
WELLS ROAD _ __ _
- ex sfin9 water ma^ DWEUJNGS - PUBUWATER
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,:THE OFFSErs (OR DIMENSIONS) SHOWN HEREON FROM THE STRUCTURES TO THE
INIOPERTY LINES ANE FOR A SPECIFIC PURPOSE MD USE AND THEREFORE ARE NOT JOB No. 01-617 FILE No. PECONIC DEVEL CORP.
MENDED TO GUIDE TFE ERECTION OF FENCES. RETAINING WALLS. POOLS. PATIOS.
PLANING AREAS.ADOIDON TD BIH.DNOS OR ANY OTHER CONSTRUCTION. SURVEYED FOR •
umuniogass ALTERATION OR ADDIDON TO THIS SURVEY N A VIOLATION OF SECTION LOT NUMBER 8
7209 OF THE NEW YORK STATE EDUCATION LAW. MAP OF PECONIC DEVELOPMENT CORP. AT SOUTHOLD
GUARANTEES INDICATED HERON SHALL RUN ONLY TO THE PERSON FDR WHOM THE SITUATED AT SOUTHOLD
SURVEY B PREPMED.-NID ON HIS BEHALF F TO TTITLE COMPANY, GOVERNMENTAL __��- --—- -- ---
AGOY AND LENDING NSRIUTION LISTED HEREON.MD TO TIE ASSIGNEES OF THE
LENONG INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE TD ADDITIONAL INSTTTUniONS TOWN OF SOUTHOLD — SUFFOLK COUNTY N.Y.
OR SUBSEQUENT OWNERS.
COPIES OF THIS SURVEY MAP NOT BEARING THE LAM SURVEYOR'S INKED SEAL OR SCALE 1" = 50' DATE 12-20-2001
EMBosaED SAL SHALL NOT BE COIBCERED TO BE A VALID TRUE COPY. FILED MAP No. I DATE
CERTIFIED ONLY TO:
TAX MAP No. (REF ONLY) 1000-70-3--P/022 DISK 500
HAROLD F. TRANCHON JR. P.C.
LAND SURVEYOR
--7-7,..A.----.4----�� ` 1866 WADING RIVER—MANOR RD. WADING RIVER.
�- NEW YORK. 11792
N.Y. LIC. No. 048992 631-929--4695
HAROLD F. TRANCHON JR. PENN. LIC. No. 2115—E
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