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Home My WebLink AboutG & N Ventures ELIZABETH A.NEVILLE = y� Town Hall, 53095 Main Road TOWN CLERK co - P.O. Box 1179 CA Southold, New York 11971 MARRIAGE OFFICER REGISTRAR.OF VITAL STATISTICS �y • �.F Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER �Ql �a� 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. 3207 R Residential x Non-Residential Fee $ 10.00 Septic x Cesspool PERMIT ISSUED TO: Name : G & N VENTURES Address 1: 30 WISCONSIN COURT City St Zip BAY SHORE NY 11706 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 #R10-04-0044 Name Of Owner G & N VENTURES ------------------------------ mailing Address 1 30 WISCONSIN COURT ------------------------------ ------------------------------ City St Zip BAYSHORE NY 11706 -------------------- -- ---------- Property Address 1 105 EAST GILLETTE DRIVE ------------------------------ ------------------------------ city St Zip EAST MARION NY 11939 -------------------- -- ---------- 7ax Map No. section 38.00 block 3 lot 11.000 ------ --- ------ Cross Street MIDLAND ------------------------------ Building Permit Number Cross Reference: ---------------------------------- issue Date: 9/02/04 Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) 3, ) 7 OG ELIZABETH A. NEVILLE �� y� Town Hall, 53095 Main Road TOWN CLERK y Z P.O. Box 1179 REGISTRAR OF VITAL STATISTICS O Southold, New York 11971 MARRIAGE OFFICERy • �� Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER l �a Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TO: Southold'town Building Department RECEIVED FROM: Linda J. Cooper, Southold Town Clerk's Office AUG 2 0 2004 DATED: July 19, 2004 Southold Town Clerk Transmitted herewith is a copy of application No. 3348 for a Cesspool/Septic Tank Construction Permit submitted by: G & N Venture 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 V DISAPPROVE _ Comments: Signature , JUl- 2 0 20 Dated 'lo ► , 1 o�g�FFO��►co ELIZABETH A.NEVILLE h`Z` Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 = REGISTRAR OF VITAL STATISTICS v. Al Southold, New York 11971 MARRIAGE OFFICER G Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER -!� 0� Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER �'� �a southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION CONSTRUCTION or ALTERATION PERMIT CESSPOOL or SEPTIC TANK Residential @ $10-zor Non-Residential @$25 Application No. J3 $ Permit No. Applicant Name 6: %L V r !4 C.-0 e a C:K4- Applicant Mailing Address "'SCJ w s rcjn S i n c T- 13-J" S'Ael e-- Septic Tank�or Cesspool Brief Description of Proposed Construction or Alteration Location of Proposed Construction/Alteration: Owner of Property: C A"' L C G - Owner Mailing Address: -�ca r e cc h s,h c T Y 5:4 Owner Property Address: /V Name and phone number of contact person S-4- S7(y-f 9d/ Tax Map No: Section Block _ Lot Cross Street_Z�2 4 J—/C"%0 NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL Signature of Applicant Date Received by: e SURVEY OF CERTIFIED T0: LOT 40 = - MAP OF JOB NO. 2004-116 MARION MANOR MAP NO.2038 SITUA TE A T RILED:MARCH 18, 1935 REVISIONS: DTHo4EASTMARION D ND.. s TOWN OF SOUTHOLD 7/2/7004 SUFFOLK COUNTY,NEW YORK S.C.T.M. DIST. 1000 SEC. 38 BLK.3 LOT 11 15 8 0 15 30 45 60 75 90 105 120 135 � SCALE. I`=30' DATE:JANUARY 29, 2004 LAND LOT AREA: 11,298 SQ.FT. =0.259 ACRE LICENSE N0. 050363 ELEVATIONS REFER TO APPROX.MSL DATUM AND ARE THE RESULT OF ACTUAL FIELD MEASUREMENTS HANDS ON SURVEYING NO SURFACE WATER EVIDENT WITHIN 300' 46 NORTH ROAD PROPERTY LOCATED ENTIRELY WITHIN FLOOD ZONE X HAMPTON BAYS, NEW YORK (WITHIN 500 YEAR FLOOD PLAIN)AS SHOWN ON THE 11946 ` FLOOD INSURANCE RATE MAP 36103CO177 G TEL:(631)-723-1954-FAX:(631)=723-1329 EFFECTIVE DATEI MAY 4, 1998 MARTIN D. HAND L.S x f Cie t p -yam p t i r s: tz 0.1EC SERv,G�OP� VEMENT EpGE OF P cp S.C.D.H.S. ENDORSEMENTS TEST HOLE DATA ooG EL.10.6 +/- N �� ♦ ^ Ga, © DARK BROWN LOAM BROWN SANDY \ `•� ` CLAY \ cn (CL) PALE BROWN \tea FINE TO COARSE SAND -10.5' Newz cjp O WATER IN PALE BROWN FINE TO G o„ y' COARSE SAND -Z�, 3 `� TEST HOLE BORING BY o - McDONALD GEOSCIENCE 6/29/2004 �g1 OIG7IMIM MMW1°It 8117E � O .is �rE°f7Ei001M�1E° B SE 70EEVN"'ON11N ' ' " 'tf"1^'q.