HomeMy WebLinkAboutCutchogue 6213 LLCELIZABETH A. NEVILLE, MMC
TOWN CLERK
TO:
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS OF MANAGEMENT OFFICER
8LDG
Tow la
Town
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, NewYork 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
luilding Department
FROM:
Carol Hydell, Southold Town Clerk's Office
DATED: August 17, 2011
RE:
Cesspool Construction Application
Transmitted herewith is a copy of application No. 4038 for a Cesspool/Septic Tank Construction
Permit submitted by:
Melissa Butler for Cntehogue 6213 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
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
~Resid;ntial (~ $10 or [] Non-Residential (~ $25
Application No.
Applicant Name:
Applicant Mailing Address:
B~f d~s~ri~ion of ~ps~d Con~6on or Alt~tion:
L~ation of Pmpo~d Con~ction/Alt~mtion:
Owner of Pm~: ~ 6213, L.L.C.
Septic Tank o[~'rrCesspool []
Permit No. c'~ 0 ~-~
Owner Mailing Address: 331 West 84th St. #4
NY, NY 10024
Property Address: 6213 Oregon Road
Cutchogue, NYl1935
Name and Telephone No. of Contact Person: Stephanie Guilpin 212-580~6502
Tax Map No.: Section: 82 Block: 02 Lot: 3.1
Nearest Cross Street: DUCK POND ROAD
NOTE: LOCATION MAP MUST BE SUBMI1-E~D WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY/~/FI~ [[P_~'i'ki DEP _AP/~MEI~T APPROVAL.
/~
Received by: ~
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
PERg,~IT FOR APPROVAL OF CONSTRUCTION FOR
SINGLE FAMILY RESIDENCE ONLY /
DATE //~,~ ~.s..~.E~-. ~o. ~/~-
EXPIRES T~ YgARS FRO:,~ DATE O~
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JEFFR
F~A~E:
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", / 8,'<PXIO'
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L.P. FOR
~ ARE NO INELL~
FEET OF pROPI~RT~
FLAN
~,0 15 0 DO
120
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T~EE~ TO BF --
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~//~/LINE OF ~ILT
FE~C,E
HAYBAL%
-- PROPOSEO 1 E~OROOH ,~EPTIC, SYSTEM,
I-2OOO ~AL. SEPTIC.. TANK ~/ I-g,' 121A.xI<::I' DEEP
L.P. (PROMIOE 50% EXPANSION)
(OOHIESTIC HATEF~ IRRI~ATION AND
FIPJ~ PROTECTION,)
NOT TO ~-~ALE
PARCEL
TOTAL. AF;~JEA = ~?I~IZ~.4-'/ ~.FT.
= 2.0-'/ ACRE5
E~ILDABLE LAND = 65,2.O2.OE, c--'-'-~.FT.
4096 CLEAREO OF TOTAL AREA
,r,~VERA(~E = 5~22 5G.FT. / ~5~.O2.O~' ~X:~.FT. = .O~ll :
LOT #4
INELL~)
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/ / LOT #5
//I (VACANT)
(NO t,'~LL~)
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