HomeMy WebLinkAbout13350 New Suffolk LLC ELIZABETH A. NEVILLEf MMC Town Hall, 53095 Main Road
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TOWN CLERK N P.O.Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS � Fax(631)765-6145
MARRIAGE OFFICER
Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER w�� �" ,r��
°� f r i° www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER . ,. "' s'g
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Sabrina Born, Southold Town Clerk's Office
DATED: January 12, 2021
RE: Cesspool Construction Application
Transmitted herewith is a copy of application No. 4935 for a Cesspool/Septic Tank Construction
Permit submitted by:
13350 New Suffolk LLC.
Please review the application and location map and advise if this office may issue the permit.
Please complete the form below and return it to me. Thank you.
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
DISAPPROVE
Comments: Final approval required„from the Suffolk County Health Department
Signature
Dated
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION r ALTERATION PERMIT
CESSPOOL r SEPTIC
Residential 10 or ❑ Non-Residential @ 25 Septic Tank ®or Cesspool ❑
Application No.
pp e it No.
Applicant e: 13350 New Suffolk LLC
Applicant Mailing Address: 40..Srr� 9cP St .S.i,it� 11
Portland, Oregon 97225
Brief description of Propsed Construction orAlteration: Construct new 8 bedroom residence
Location of Proposed Construction/Alteration:
Owner of Property: 13350NewSuffolk LLC
Owner MailingAddress: 10490 SW Eastridge St, Suite 110E
Portland, Oregon 97225
Property 13350 New Suffolk Ave
utchoue, NY 11935
Name and Telephone No. of Contact Person: Greg Eicher-516-650-3957
Tax Map No.: Section: 116 lock: 6 Lot: 20.2
Nearest Cross Street: s
NOTE:
CONSTRUCTION1T':l l HEALTH DEPARTMENT APPROVAL.
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January 11, 2021
/iigg, re of Applicant Date
Received
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4" SDR' :AN5PORT PIPE(TYPIGAL,U.O.W WA5TE 6 ;TREATMENT 5Y5TEM5 REQUIRED BY
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SANITARY GOMPONENTS UPON INITIAL INSTALLATION" EN-GON5ULTANT5 ON APRIL 08, 201G —
UTILIZE EXI5TIN6 TAP, RUN
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