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HomeMy WebLinkAboutG&N Venture ELIZABETH A. NI~VII,!,E TOWN CLEHIK REGISTRAR OF VITAL STATISTICS MAltI~.L~-GE OFFICER RECORDS 1VL, kNAQEMENT OFFICER FREEDOM OF INFOP~J~TION OFFICER Town Hall, 53095 Main Road P.O_ Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.nor~kfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: FROM: DATED: July 19, 2004 Transmitted herewith is a copy of application No. Permit submitted by: G & N Venture Southotd Town Bui/ding Department Linda J. Cooper, Southold Town Clerk's Office 3348 for a Cesspool/Septic Tank Construction Please review the application and location map and advise if the project has received Suffolk County Health Department a. pproval 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 ColBrneRtS: Signature Dated ELIZ.~BETH A. NEVI1,LE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MA/~AGEMENT OFFICER ~FREEDOM OF INFOB,IVlATION OFFI©ER Town Hall, 53095 Main Road P.O. Box 1179 Sou(~hold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 s outho Id~o ~rn ~or~h~ork.net OFFICE OF THE TOWN CLERK TO~VN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PER34IT CESSPOOL or-SEPTIC T.4aNK Residential ~ $10 or Non-Residential ~ $25 __ Applicant Name Applicant Mailing Address Application No. ~ ~{% Permit No. Septic Tank v/or Cesspool Brief Description of Proposed Construction or Alteration Location of Proposed Construction/Alteration: O~merofProperty: (~ <..A/ 6/'~,q ~'*.,,~.e_ Ow-ner Mailing Address: ~co t,.~ ~< co~ $',,~ Ovrner Property Address: /'~ ~- Name and phone number of contact person t-),,_,~r Tax Map No: Section r~'~?6~ - Block Cross Street /4% o/~e/~. ,, S~ture of Applicant ~ Date Received by: '~) NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTS~ENT APPRO~ AL LOT40 MAP OF MARION MANOR SITUATE A T EAST MARION. TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C.T.M. DIST. 1000 SEC. 38 BLK.3 LOT 11 .15 8 0 15 30 45 60 75 90 105 120 SCALE: 1' = 3~ DATE: JANUARY 29, 2004 LOT;AREA: 11~298 SQ. FT. = 0.259 ACRE ~ EL~'VATIONS REFER TO APPROX. MSI- DA TUM AND ARE THE RESULT OF ACTUAL FIELD MEASUREMENTS NO SURFACE WATER EVIDENT WlTHIN 300' PROPERTY LOCATED ENTIRELY WITHIN FLOOD ZONE X ~!N 500 YEAR FLOOD PLAIN) AS SHOWN ON THE '."F.£oOD~INSURANCE RATE MAP 35103C0177 G EFFECTIVE DATEI MAY4, 1999 135 JOB NO. 2004-116 MAP N0.2038 FILED:MARCH 18, 1935 REVISIONS: REV. PLO TPLAN 3/8/04 ADD 2ND. TEST HOLE 7/2/2O04 LICENSE NO. 050363 HANDS ON SURVEYING'~ ' 46 NORTHROAD ' . HAMPTON BAYS, NEW YORK ~ 11946 · ,~t TED (631)-723-1954 - FAX:(651)=-/23-~I329 - ~ MARTIN D. HAND L.~ ENDORSEMENTS ~E DA TA -- EL'IO. 6' +/- DARK BROWN LOAM (OL) -1.0' BROWN SANDY CLAY (CL) -4.0' PALE BROWN · - ~': ....... FINE TO COARSE SAND -10.5' WATER IN PALE BROWN FINE TO COARSE SAND -17.0' TEST HOLE BORING BY McDONALD GEOSCIENCE 6/29/2004