HomeMy WebLinkAboutDunne 4 -• �j, ®sUFFOI
JUDITH T.TERRY ��_�® oG'L� Town Hall, 53095 Main Road
TOWN CLERK y P.O. Box 1179
d Southold,New York 11971
REGISTRAR.OF VITAL STATISTICS O 47$
MARRIAGE OFFICER y �1 Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER 411; ®�( $ ' .' Telephone (516) 765-1800
FREEDOM OF INFORMATION OFFICER ��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3629-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner DU N N E
Mailing Address 1 C/O 'ELE DEVELOPMENT
Mailing Address 2 P. O. BOX 1143
City St Zip CUTCHOGUE NY 11935-0000
Property Address 1 670 GABRIELLA COURT
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 000-000-0000
Tax Map No. section 108.00 block 4 lot 7.024
Cross Street ELIJAH'S LANE
Issue Date: 5/15/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
3 c)--7.
OFFICE OF THE TOWN CLERK VFFl7(,- "=
Town of Southold Application No._
Judith T. Terry, Town Clerk y
Town Hall, 53095 Main Road 8 -< $10.00 - Residential
P. O. Box 1179 cr3 $25.00 - Non-Residential
-;:: ► `'
Southold, New York 11971 OO
Telephone .( 0-10°.'`
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE 111-tet:9-
,
OWNER NAME: vUnnC
OWNER MAILING ADDRESS: 610 C'1 fibre i l: ( ( a Ct'
ai-+i-Fc,tcls y J\. \/ 119,52_
OWNER PROPERTY ADDRESS: S IrrY1C__.
OWNER TELEPHONE NUMBER:
TAX MAP NO. : Section I C% Block 14 Lot
CROSS STREET: E1 1`etC..
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool ✓ New Existing
Residential Non-Residential
LOCATION MAP: Must be attached hereto before permit may be issued.
(Locate building and system; give north arrow and feet
of distance, approximately, to building and closest road.)
i ,1
igna/PIica n t
RECEIVED BY:
Town Clerk's Office
DATE:
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o0�� It'N SURVEY OF
�� moo. LOT 19
v� so "ELIJAHS LANE ESTATES, SECT. 2
U 'O,_ FILED OCT. 8, 1996 FILE NO. 9912
R • 25.00' AT MA T TI TUCK
L • 3927'
TOWN OF SOUTHOLD
'92 '
H� �
SUFFOLK COUNTY, N. Y.
\\\' 9, r•" \ 1000 - 108- 04 -P/O 7.1
���, D /" Scale: 1"= 40'
,,\ ' . „--- Dec. 4, 1996
.p r 5 V O� SUFFC'K COUNTY DEPAR i IOMT• i OF MALTA.SL VICE
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�• P .' T FOR AMOVAL C --rZI;cizO:,iOR A
a « S+u”iGLE FAE'*'Y=SEN.=ONLY
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0. t % DATE �ic�11; as gm Iia ¢�c -D L�T
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and APPROVED i eAkI.T.!is il�J;p-,
CJ\<- s \\ i C'G FOR MAXLMUM OF la
1 BEDROOMS
e
:FIRES THREE YEARS FROM DATE OF APPROVAL
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AR(A = 40;442 sq.ft. = - * 1
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ANY A>(.er7ATTON OR ADDITION TO TNS SURVEY SA VIOLA;lay I cm Icr"ilsar with the STANDARDS t"--)R APPROVAL The Iocsiicis of wells ord cesspools . 4, czi
OF SECTION 7209 OF THE NEW YORK STATE EOUCATION LAM, AND CONSTRUCTION ION OF SC BSURFA SEWA.E shown hereon are ',om field observe- ' � 49-1 -, yC. 49619 �j
EXCEPT AS PER SECTION 7209-SUBDIVISION Z. ALL CERTFKATICHS DISPOSAL SYSTE.WS FOR SINGLE F:V/LY RESIDENCES end or from deo oblcined from others. /)"` + An S
HEREON ARE VALID FOR THfSMAP APO COPES Trc.REOF ONLY:F 1 . �(
SAID MAP OR COPES BEAR THE 3/PRESSED SEAL OF THE SURVEYOR cod will ,^ide by the conditions set for, there'.^, cod on the PECONI_ SURi/EY— .C. 4
NHOSE SIGNA TtE APPEARS HEREON. permit to construct. 15161 765 - 5020
ADDITIONALLY ro COfoLY WITH SAO LAW THE TERM 'ALTERED BY' P. 0. BOX 909
MUST BE USED BY ANY AND ALL SLAiVEYORS UTCRING A COPY ELEVATIONS ARE REFEREtYc 1230 TRAVELER STREET
.2F ANOTHER SURVEYOR'S MAP. TERMS SUd AS 'J-SPECTER'AND TO AN ASSUMED DAT UK SOUTHOLD, N.Y. 11971
BROUGHT-T D-DAY.ARE NOr N COiRUHr_E MITT THE LAM.
96 - 317 19