HomeMy WebLinkAboutMitchell, StephenELIZABETH A. NEVILLE, MMC
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
www.southoldtownny.gov
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Carol Hydell, Southold Town Clerk's Office
DATED: May 13, 2015
RE: Cesspool Construction Application
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Transmitted herewith is a copy of application No. 4315 for a Cesspool/Septic Tank Construction
Permit submitted by:
Ray Nemschick for Mitchell
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:
V
APPROVE
DISAPPROVE
Comments: Final approval required from the Suffolk CountyHealth Department required from the Suffolk County Health Department
Signature ►(/'
Dated
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631) 765-6145
Telephone (631) 765-1800
southoldtown.northfork.net
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $10X or Non -Residential @ $25 Application No.
Permit No.
Applicant N;
Applicant Mailing Address
(X M
sc
Septic Tank K or Cesspool , j,�� CGS
Brief Description of Proposed Construction or Alteration jw
Location of Proposed Construction/Alt ration:
Owner of Property: r7 f 403 2 S'j lr— 1 V0'
Owner Mailing Address:
Owner Property Address: )(40,
Name and phone number of contact person
d
Tax Map No: Section Block Lot_
Cross StreetZS
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
Si icant Date
Received by:
NEiq POLIG
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EX15T. 5,
5Y5TEM
LOT DEPTH.
163 FT
FRONT YARD:
46,
11/9.26 FT
51DE YARD:
15 FT
BOTH 51DE rAR125.
35 FT*
59.0 FT
REAR 'rAR9.
60 FTI
117.60 FT
LIVABLE FLOOR AREA:
650
MAXIMUM PERMITTED Dff-EN51ON5:
LOT COVERAGE OERCENT)
209
1636
BUILDING IE16HT
35 FT
34 Fr
5TORIE5
2112
2
NONCONFORMING LOT REOUIREMENT5 FOR 20,000 TO 39999 5.F. AREA PER 200-1248
BVILD/W5, AREA5
CELLAR
FIR5T FLOOR 5ECON9 FLOOR
LIVABLE AREA
'2A27
5,065 - 4,524
FA T105 / TERRACE5 / DECK5
---
2,107 414
GARAGE
672 ---
HEALTH DEPARTMENT APPROVAL 5TAMP
SUFFOLI'%. COUN-i Y DERARTNIENT OF HEA Ut 11 SERVICES
PEnmiT FOR APPROVAL OF CONSTRUCTION FOR A
SINGLE FAwjILy tiEsmna ONLY
.S. REF. No, iq -coll _1
DATE _,ic
APPROVED
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FOR MAXIMUM OF _—EmRooms
EXPIRES THREE YEARS FROM DATE OF APPROVAL
OCT i 4 2014
SUVV. COF�
HEALTH SE
n;:FICE LLAST_EWAI
SEAL E D REVISIONS/SUBMISSIONS: DRAWING TITLE:
W. DATE: DESCRPTION:
07108114 50% REVEW
10/22/14 fCDHj
JIM PLM
-7-029086 -ko CAD FILE NAME:
Of N
1 1770 PRI
PROJECT TITLE: DATE: NSA PROJECT
MITCHELL RUIPMCL 07/08/:14] 15 1770
7152 1/11)IA/I /PECK RI)
.. .......... . . Pr-CONC, IIX 119,58 SCALE: DRAWING NO.:
AY /10TU)
DISTRICT: SECTION: BLOCK: LOT: DRAWN BY:
!014 NEMSCHCK SLVERMAN ARCHTECTS P.C. 1000 8 6 7 8 r-cr
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