HomeMy WebLinkAboutSt Pierre, Donna (2) ELIZABETH A.NEVILLE =Z *•- Town Hall, 53095 Main Road
TOWN CLERK o - P.O. Box 1179
Southold New York 11971
REGISTRAR OF VITAL STATISTICS f '
MARRIAGE OFFICER � 41. 1� � Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ; �Q � )toi 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. 3189 R Residential x Non-Residential
Fee $ 10.00 Septic x Cesspool
PERMIT ISSUED TO:
Name : HARBORVIEW HOMES INC
Address 1: 1706 COUNTY ROAD 39
City St Zip SOUTHAMPTON NY 11968
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR ONE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-04-0047
Name of owner ST. PIERRE, DONNA
Mailing Address 1 4 SILVER AVENUE
City St Zip HUNTINGTON STATION NY 11746
Property Address 1 480 PINE AVENUE
City St Zip SOUTHOLD NY 11971
Tax Map No. section 77.00 block 3 lot 8.000
Cross Street HICKORY AVENUE
Building Permit Number Cross Reference:
Issue Date: 9/01/04 Elizabeth A. Neville
Southold Town clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE iid% Town Hall, 53095 Main Road
TOWN CLERK CCA Z �� P.O. Box 1179
REGISTRAR OF VITAL STATISTICS O ��, Southold, New York 11971
MARRIAGE OFFICER
0. Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER ,`=jl ( * -0,.,,,, Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER .6'-~,.,..01°°- southoldtown.northfork.net
. - 6 'Z OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
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TO: Southold Town Building Department
2.604
FROM: Linda J. Cooper, Southold Town Clerk's Office
Southold Town Clerk
DATED: June 4, 2004
Transmitted herewith is a copy of application No. 3330 for a Cesspool/Septic Tank Construction
Permit submitted by:
Harborview Homes, Inc. for Donna St. Pierre
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 1.J/
DISAPPROVE
1 \
Comments: ►
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ELIZABETH A.NEVILLE ►�
/ifs Gy�` Town Hall, 53095 Main Road
TOWN CLERK co - , P.O. Box 1179
REGISTRAR OF VITAL STATISTICS W t Southold, New York 11971
MARRIAGE OFFICER : '� 1� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER V** * a��►►►1 Telephone (631) 765-1800
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FREEDOM OF INFORMATION OFFICER 91 ►,► southoldtown.northfork.net
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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.6 3) 3 0
Permit No.
Applicant Name Harborview Homes, Inc.
Applicant Mailing Address 1 706 County Road 39, Southampton, NY 11968
Septic Tank x or Cesspool x
Brief Description of Proposed Construction or Alteration construct a 2 story
4 bedroom one family dwelling
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 Oppedisano, 287-0772
Tax Map No: Section 77 Block 3 Lot 8
Cross Street 368 ' Bi/O Hickory Ave.
NOTE: LOCATION MAP MUST BUB ITTED ITH • ' ` ICATION. NEW
CONSTRUCTION REQUIRES SURVWY WITH HE• T . DEP•A'T NT APPROV
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re of pli II.te
Received by: ,
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' `s SbbliNys APPROVAL OF CONSTRUCTION FORA c12
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SURVEY OF CERTIFIED TO:HL ENTERPRISES,INC.
LOTS 21 THROUGH 29 '
MAP OF 1
JOB NO. 2004-154 ,..
GOOSE BAY ESTATES 4 OF N:_#�, y-
SITUA MAP N0.1176
FILED:NOVEMBER 13, 1934 kt• �oomet `,
REVISIONS:ADD ADJ.WELLS&SAN. ,,fit
SOUTHOLD �5r2004 \
TOWN OF SOUTHOLD * ft 1 " , >.
SUFFOLK COUNTY, NEW YORK
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S.C.T.M. DIST. 1000 SEC. 77 BLK. 03 LOT 8 06 �r 4' 3 •1`''
�� CAND
.� �. MI MIIINIMOM
15 8 0 15 30 45 60 75 90 105 12' 135
SCALE: i"=30' DATE:MARCH 3, 2i LICENSE NO. 050363
LOT AREA:22,500 SQ.FT. =0.517 ACRE
ELEVATIONS REFER TO APPROX. MSL DATUM ,
AND ARE THE RESULT OF ACTUAL FIELD MEASUREMENTS DWELL • •
NO SURFACE WATER EVIDENT WITHIN 300' HANDS ON SURVEYING
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46 NORTH ROAD ,
0 HAMPTON BAYS, NEW YORK -.: '
4-4t 11946 , `
TEST HOLE DATA ;o a _ \ TEL:(631)-723-1954-FAX:(631)-723-1329
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TOPSOIL -1.0' k-co O
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