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JUDITH T.TERRY 1 = Town Hall, 53095 Main Road
TOWN CLERK ; y $41 P.O. Box 1179
Z Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
‘‘?$ 4� 4 ',� Fax(516) 765-1823
MARRIAGE OFFICER #
RECORDS MANAGEMENT OFFICER �_�0,( $ ,I Telephone (516) 765-1800
411
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1665 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : ELE DEVELOPMENT CORP.
Address 1 : P. O. BOX 1143
City St Zip CUTCHOGUE NY 11935
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. SCHD REF. #R10-97-0035
Name Of Owner ELE DEVELOPMENT CORP.
Mailing Address 1 P.O. BOX 1143
City St Zip CUTCHOGUE NY 11935
Property Address 1 GABRIELLA COURT
City St Zip MATTITUCK NY 11935
Tax Map No. section 108.00 block 4 lot 7.023
Cross Street ELIJAH'S LANE
Building Permit Number Cross Reference:
Issue Date: 5/15/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
r /,,,/II / -S
Off' C� •
JUDITH T.TERRY t _� Gym Town Hall, 53095 Main Road
TOWN CLERK ; y P.O. Box 1179
v P �� Southold, New York 11971
REGISTRAR.OF VITAL STATISTICS O 0
Fax (516) 765-1823
MARRIAGE OFFICER y 1
_go.j
RECORDS MANAGEMENT OFFICER ./ Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED : April 23, 1997
Transmitted herewith is a copy of application No. 1728 for a Cesspool/
Septi: Tank Construction Permit submitted by:
ELE DEVELOPMENT .
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.
Thank you.
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recommendations:
APPROVE
DISAPPROVE
Comments:
RECEIVED / y
MAY 1 4 1997 Signa ure
Date.
Southold Torn Clock
OFFICE OF THE TOWN CLERK ,'''''''''''''•
Town of Southold .0fOtkC
Town Clerk %'' o SG Application No./72
Judith T. Terry, � ';
k.
Town Hall, 53095 Main Road .� • Construction
P. O. Box 1179 ; v ac
Southold, New York 11971 cn Alteration
t.
Telephone 0 ° � �/ $10.00 - Residential
(516) 765-1801 .�I alit
•,�'' $25.00 - Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE
APPLICANT NAME: 6 . L . E ( opt-nc 1 7- CO✓ p
APPLICANT ADDRESS: P C> . tiOx. I [Li-3 I
ct
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: m L
OWNER MAILING ADDRESS: Prirn C.
OWNER PROPERTY ADDRESS: .K}-I(-r)
TELEPHONE NUMBER OF CONTACT PERSON : 77-2. —S'S Li 0
d
TAX MAP NO. : Section 1 S r
Block `rt Lot -7 . 23
CROSS STREET: E ( � Int- h '
BUILDING PERMIT NUMBER CROSS REFERENCE:
igna a of Applicant
RECEIVED
RECEIVED BY :
TowAPRIet 'l991Ifice
DATE:
Southold Town Clerk
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SUVEY OF
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6. `l• ts% LOT :19
"ELIJAHS LANE ESTATES, SECT. 2
's FLED OCT. 8, 1996 FILE NO.9912
�. AT MA T TI TUCK
\g2° TOWN OF SOUTHOLD
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a.y2 6 ��'n • SUFFOLK COUNTY, N. Y. .
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\ , 1000- 108- 04-P/07.1
�� Q Scale: 1"= 40'
$� s��\� vA. P Dec. 4, 1996
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gumptcg ONLY
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00198.46 APPROVED 5r i
FOR„alum„alumMS
o EXPIRES nom
YEARS FROM DATE OF APPROVAL
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i ‘Of kit
7 .
AREA = 40,033 sq.ft. ; _;1
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ANY ALTERATJON OR ADpT70N TO THS SURVEY/S VIOLATION l m /c:-Nor with the STANDARDS FOR APPROVAL The locations of wells and cesspools . -
OF SECTION 7209 OF The NEW YORE STATE ED<JCIT7ON LAW AND CONSTRUCTION OF SUBSURFACE SEWAGE shown hereon are from field observations / ..° e9
EXCEPT AS PER SECTION 7209 SLECYV75ON Z ALL C£RTMgCAT10N5 DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCESl /. 31j C NO. 49618
HEREON ARE VALD FOR Thrs-,LAp AND COPIES THEREOF OACY 1F and or from dma obtained from olAers. �r�,tlMBs
SAID.MMP OR COPES BEAR The MIPRESSED SEAL OF The SURVEYOR and will abide by /he conditions set forth therein and on lhs PECONIC SUR' "*”.0
• 71F705E SIGNATURE APPEARS hfR£OM permit to construct. (516) 765 - 5020
ADOITIONALLY TO COMPLY M►TN SAD LAW THE TERM 'ALTERED BY' P. 0. BOX 909
. MUST BE USED BY ANY AJNO ALL SURVEYORS UTh7ZIXf A COPY ELEVATIONS ARE REFERENCED 1230 TRAVELER STREET
OF ANOTHER SURVEYOR'S,HAP. TERMS SUC1 AS 'INSPECTED'AND To AN ASSUMED DA TWA SOUTHOLD, N.Y. 11971
;BROUGHT-TO-DATc ARE NOT N COMPLIANCE MYTH The LAM.
96 -317 18