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ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE 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
southoldtown.northfork. net
clAN 2 .9
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
to:
Southold Town Building Department
"~_-1
FROM:
Michelle L. Martocchia, Southold Town Clerk's Office
DATED:
January 29, 2007
RE:
Cesspool Construction! Alteration Application
Transmitted herewith is a copy of application No. 3661
Construction/Alteration Permit submitted by:
for a Cesspool/Septic Tank
Misook Kim
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.
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I have reviewed the application and location map of the project cited above and make the following
recommendations:
APPROVE
/
DISAPPROVE
Comments: ~r~~1f:~~~- ~~~
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Signature
O//30~7
, .
Dated
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
Town Hall, 53096 Main Roe'
.J P.O. Box 1179
Southold, New York 11971
Fax (631) 766-6145
Telephone (631) 765-1800
sou tholdtown .northfork. net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $10 / or Non-Residential @ $25 _
Applicant Name f'.A.1.s0()~ ~ I t-\
Applicant Mailing Address ,Pee Wet"- P i.
\2.4- ~ 0... Po..r Je~ 1l~ r u'( WPV1
Septic Tank_or Cesspool
BriefDescriptioll of propose<((;~~tI-uct~or Alteration
Application No 3\0 \" I
Permit No.
C u, i ~ -8 I (p
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Location of Proposed Construction/Alteration:
Owner of Property: riel:> ulP.e,+- ~
Owner Mailing Address: \ 1.."- A-I,)<A-...
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Owner Property Address: rPCY:"l 1J.Je<.-\- U
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<'- (nl-c..ho~ (,\..<2..
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('u~\...3'u€
Name and phone number of contact person
Tax Map No: Section 110
,
Cross Street
t-\\.s~
Block
~ll-1
5"
6~1 )
Lot
641"'l-1,(60~
44
pe.-~~
NOTE: LOCATION MAP MUST BE SUBMITrED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH REALm DEPARTMENT APPROVAL
--- ~ ') <
-Bfgnature of Applicant
Received by:
Date
SURVEY OF PROPERTY
SITUATE: CUTCHOGUE
TOHN: 5OUTHOLD
SUFFOLK COUNTY, NY
UlKlll'mLJ TO:
N
W-t-E
S
SURVEYED, OGTOBER 25, 2006
SUFFOLK COUNTY TAX II
1000-110-5-44
MiIootKim
Abandonm
CO f( ent of existin 0
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AREA: 31,5IB S.F. OR 0.0013 ACRES
EXISTING HOUSE TO BE REMOVED
PROPER1Y ZONE R-40
PROPOSED HOUSE FOOTPRINT 2;300 SF OR 6.1% C
FLOOD ZONE X
ELEVATIONS REFERENCE SUFFOLK COUN1Y TOPO MAPS
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JOHN C. EHLERS LAND SURVEYOR
6 EAST MAIN STREET N.Y.S. lie. NO. 50202
RIVERHEAD, N.Y. 11901
369-8288 Fax 369-8287 REF.\\CompaqserveI\pros\06\06-246 REV FOR IID.pro