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JUDITH T.TERRY �l��O Gym Town Hall, 53095 Main Road
TOWN CLERK y ' P.O. Box 1179
P � Southold, New York 11971
REGISTRAR OF VITAL STATISTICS :‘44 / � Fax (516) 765-1823
MARRIAGE OFFICER \** %�l/l
RECORDS MANAGEMENT OFFICER �� * ��;s106 Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER 4.4'••~, i40
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1602 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. #R10-97-0026
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 11952
Tax Map No. section 108.00 block 4 lot 7.034
Cross Street ELIJAH'S LANE
Building Permit Number Cross Reference:
Issue Date: 3/20/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
r,r��SVFFO��c
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JUDITH T.TERRY ,1r ytN Town Hall, 53095 Main Road
TOWN CLERK y% •
2 P.O. Box 1179
• •
• Southold, New York 11971
REGISTRAR OF VITAL STATISTICSO
MARRIAGE OFFICER ��y r�1 Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER = 491 `1►pp rrr 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: February 25, 1997
Transmitted herewith is a copy of application No. 1676 for a Cesspool/
Septic Tank Construction Permit submitted by :
E L E Development Corp.
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.
41_,-x...61
Linda J. Cooper
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited ate}cve
and make the following recommendations:
APPROVE
DISAPPROVE
Comments:
RECEWED
MAR 1 9 1997 Signature
3/ /
�, qr 3 az Dated /�
JLutuccc
(1i=1=ICL OF FIIE TOWN CLERK O1+C���FFO(I'`O
Town of Southold •
Judith -T . -Terry, Town Clerk Application No. Ae.71 '�
Town Ilall, 53095 Main Road ` Construction
P. 0. Box 1179 -- ------
Southold, New York 11971 O BJ Alteration
'01 . $'%6\).1°'°,
Telephone Residential
(516) 765-1001 Non-Residential
•
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL .
Permit No.
Fee $
DATE ,2-44Z
APPLICANT NAME: t7k-
ik!/fOQIirJ c'.o_._ .__-
APPLICANT ADDRESS: ,C) 30Y .z ,
--_C .1itD._CrV /12!/_.___ _//135.7-_-_______________-----_._._--
SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must he attached hereto before permit may be issued.
• LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION :
OWNER OF PROPERTY : '
OWNER MAILING ADDRESS: 5W
OWNER PROPERTY ADDRESS : /!1L_
TELEPHONE NUMBER OF CONTACT PERSON :_ ?.Z2-5'g9a
TAX MAP NO. : Section Block C.) & Lot 4
CRC)SS STREET :
BUILDING PERMIT NUMBER CROSS REFERENCE :
49
5i nat of Applicant
J
RECEIVED BY ;
Town Cleric's Office
DATE :
• C t
ST or
I
d 17----s pr SURVEY OF
LOT 10
7' "ELIJAHS LANE ES TA TES, SECT. 2
FILED OCT 8, 1996 FILE NO 9912
/ 'G �`�0A T MA T TI TUCK
G c cPt1L 0 TOWN OF SOUTHOLD
��` lee
„ � 0 SUFFOLK COUNT Y, N Y.
e G 1000 - 108 - 04 — P107.1
,I8 'A Scale: 1” = 40'
Dec. 4, 1996
D T3
. s • -I
(2, 0
O. D A&T' rOF HEALTh, RVICES '
S�UIt �i�•COUNTY
pspucT FOR APPROVAL OR CONIFTRUCIWN FM,A.
snout FAMZLT . -a.. . « omLY
R = 25.00'
L = 39.27' 0 . 97 us REF ,: it... ^`>DD A
i rift
a(Ia APPROVEDTO MAXIMUM OF BEDROOMS
J /‘%
P EXPIRES THREE YEARS FROM DATE OP APPROVAL
_
.C41'
` <n\ d` t.
C
i t j.
l am familiar with the STANDARDS FOR APPROVAL The locations of wells and cesspools . L==° ' 4 r
AND CONSTRUCTION OF SUBSURFACE SEWAGEshown hereon ore from field observations do 6�e 4,Oc Lin M
DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES and of from dole obtained from others. • ' I, i-c' • i;��r'i . ` ,, ,. :". ; 1