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Home My WebLink AboutSt Pierre, Donna ELIZABETH A. NEVILLE TOWN CLERK REGISTP. AR OF VITAL STATISTICS i~IARRIAGE OFFICER RECORDS i~LKNAGFaN~ IEN~ OFFICER ~BF~D ©M-O F'INF O I~L~.T ION OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1500 southoldt o~m.northfork, net TO: _]t~ - ~ 9~.~' -~" OFFICE OF TIlE TOWN CLERK TOWN OF SOUTHOLD Southold Town Building Department FROM: Linda J. Cooper, Southold Town Clerk's Office DATED: June 4, 2004 Transmitted herewith is a copy of application No. 3330 Permit submitted by: for a CesspooUSeptie Tank Construction Harborview Homes, Inc. for Donna St. Pierre Please review the application and location map and advise if the project has received Suffolk Cotmty Health Department approval and if this office may issue the peri.it. 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 recomrqendations: APPROVE DISAPPROVE Signature ELIZABETH A. NEVIIJ,E TOWN CLERK REGISTRAR OF VITAL STATISTICS NiARRL~GE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 sou~holdtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential @ $10 x or Non-Residential @ $25 __ Application No. 3 ~ 30 Permit No. Applicant Name Harborview Homes, Inc. Applicant M~JlingAddress 1706 County Road 39, Southampton, NY 11968 Septic Tank x or Cesspool x Brief Description of Proposed Construction or Alteration 4 bedroom one family dwelling construct a 2story Location of Proposed Construction/Alteration: OwnerofProperty: Donna St. Pierre Owner Mailing Address: 4 Silver Ave. , Huntington Station, NY 11746 Owner Property Address: 480 Pine Avenue, Southold Name and phone number of contact person Richard OoDedisano., 287-0772 Tax Map No: Section 7 7 Block 3 Lot 8 Cross Street 368 ' !~/0 Hickory Ave. NOTE: LOCATION MAP MUST B~0-~ED WITH API~LICATION. NEW Received 6y ~/Si~x~e °f SURVEY OF LOTS 21 THROUGH 2g MA'P OF GOOSE BA Y .E, STA TES Si TUA T ' T SOUTHOLD' TOWN OF 80UTHOLD SUFFOU(' ~OUNTY, NEW YORK S.C.T.M, DIST. fO00 SEC, 77 BLK. 03 LOT 8 f5 8. 0 . '15 30 45 60 75 90 105 SCALE: 1" = 30' DATE: MARCH LOT AI~EA: 22~500 SQ. ET. = 0 5'i7 ACRE ; E/~E~'AT/ONS REPER TO:APPROX. MSL DATUM i AND~RE THE RESULT OF ACTUAL FIELD MEASUREMENTS ~0 ,.qURFACE WATER EVIDENT WITHIN 300' TEST HOLE DATA · TOPSOIL -I.0' PALEBROWN MEDIUM SAND -5.0' p, CE S~OWN · FINE TO MEDIUM SAND -17.0' CERTIFIED TO: HL ENTERPRfSES, INC. JOB NO. 2004-154 MAP NO. 1176 FILED: NOVEMBER 13, 1934 REVISIONS:ADD ADJ. WELLS& SAN. 5/25/2004 135 LICENSE NO. 050363 HANDS ON SURVEYING" 46 NORTH ROAD HAMPTON BA YS, NEW YORK ~ 11946 ' TEL: (631)-723-1954 ~,FAX.'(631)-723-1329 MARTIN D. HAND I_S ADJOIN NG WELL AND SANITARY INFORMATION BY OTHERS A.= .OT ~U^~.TEED v~.. ~'--.. ~ ~. _ ,~, ~, I / / / -.L ,--. :~ ..... /,,~ / / I / ~ ....... ' ~ '"/~ - ~ / / / g . ~ '~ ,"~, / ~ [ / '/ , ~ ~ ~X ~ ~ ~ · m ~ ~ ~ ~. 0 ~.. . .¢ ~ x · ~ ., ~ =~ = , , ,.¢ /~ f_~_~ ~ .~. '~ ~ ~=. ~ .- '~ ~. ~ : ~ %~ ~ m~ '.: ....