HomeMy WebLinkAboutFoster JUDITH T.TERRY ��� '44 Town Hall, 53095 Main Road
TOWN CLERK ; g P.O. Box 1179
a• �` Southold,New York 11971
REGISTRAR.OF VITAL STATISTICS
MARRIAGE OFFICER � � Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER = � *too.' Fax
(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. 3612-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner FOSTER
Mailing Address 1 C/O ELE DEVELOPMENT CORP.
Mailing Address 2 P. O. BOX 1143
City St Zip CUTCHOGUE NY 11935-0000
Property Address 1 870 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 7.025
Cross Street ELIJAH'S LANE
Issue Date: 4/30/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
1-010-krq5C20
34 /')-
OFFICE OF THE TOWN CLERK CI\FFu -
Town of Southold 14% Application N -,
Judith T. Terry, Town Clerk kk - arr
Town Hall, 53095 Main Road g $10.00 - Residential
P. O. Box 1179 �' ' "` ' $25.00 - Non-Residential
Southold, New York 11971 190./
i� �` 'V�O •'`�
Telephone = .( j
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE '4-l l —( l cZ�-
OWNER NAME: F0 +E-
OWNER MAILING ADDRESS: Sri Q. 2 bra -. ( I ac
M z -�-t-i+�� k a .•/ ( 1. 952._
OWNER PROPERTY ADDRESS: Prm�
OWNER TELEPHONE NUMBER:
TAX MAP NO. : Section ( d� Block 4 Lot —7 a aS
CROSS STREET: E- I j j pr h ' S toc--
TYPE OF SYSTEM: Septic TankNew Existing
Cesspool �r 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.)
!gnat of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
•
N 0 Baa /O (s2X
a. O <
sos
1.
IC:t
O 26h c. c `r-
• •
-
. - ir,
P O Sjk ,4
6�s� SURVEY OF
a <o a „
` •
� � LOT 20
�00 �`'' `r�` "ELIJANS LANE ESTATES, SECT. 2
f R: z�D° �.). FLED OCT. s, 1996 FILE NO. 9912 -
AT MA TTI TUCK
" TOWN OF SOUTHOLD
, NSo • ,r• �''L SUFFOLK COUNTY, N Y.
•�92 1000- 108- 04 -P/O 7.1
ca. h2 R. I - /! /
tv
�•�\ / �o�, SDec. 4, 1996 - .
\ 5;" ,-'\ e /
eM, Z ' d'../.. "S �0 6
I �` to ,o p l e�� 2669
/ ---• -�S' / O_ /
V. / f 3L'rFOLI:COUNTY DZoA I 0 MALTh SLRVICES
a0• `74 \
P£RB"fF
AP' AL CQ.fG,^brm�mcIO
N FOR
A -
t- a S GLE FA.fLY^Pr. ifC:P04LY
`�J\ R
\ / ` G; t
DATE. FEB e Hs v �fi, 1t _r1
r
APPROVED 4 � �Q `
z - FOR MAXIMUM WO_BEDROOMS
'`r '%* EXPIRES THREE YEARS FROM DATE OF APPROVAL
'so g
SO••
5.
p ,F'oE NE*
(...e\e‘.71 \ , 04 T.At.e216
AREA = 40,011 sq.ft. ' a 3 �`
ANY ALTERATION OR ADLYT7ON TO MS SURVEY IS A VIOLAT70N I am familiar with the STANDARDS FOR APPROVAL The locations of wells and cesspools . ,u.,„�° 496t _t., ,...,1:4.,r,:,,..',....0.'
OF SECTION 7209 OF THE NEW YORK snarl'EDCKAT]CM J1,
' AND CONSTRUCTION OF SUBSURFACE SEWAGE shown herc+on are lrom Ifeld observations ,�_c� =j��3{ g/�k;
EXCEPT AS PER SEC;xw 7209-SLOXV/SION z ALL C£RTF7CA TIONS DISPOSAL SYS TENS FOR SINGLE FASfILY RESIDENCES and of from data obtained from others. t= '�^�'
HEREON ARE VALD FOR THS1 AP AW COPIES THEREOF ONLY f
SAID VAP OR COPES SEAR THE SP.RESSED SEAL Of THE SURVEYOR and will abide by the conditions set forth therein and on the PECONiC. SURVEYORS, P�C� ' .,
?CHOSE SIGNATURE'APPEARS HEREOK permit lo construct. (316) 765 - 5020 jl°,�'� 19 ;y9l
OX 909
US F USEDTsr AN_ ArLY SURVEYORS D LAW 'ALTERED ar EL.EVA TAONS ARE r?£FERENCW 1230 BTRAVELER STREET 'yJ iViseA i°
F ANN H6R DARE NOT N reads SUC1 AS COWL ! THE LA1Wt ANO TO AN ASSLUED OA rum. - SOUTHOLD, N.Y. 11971 ' k egolgil
-
• - 96-317 20-._--- •
Z '0 01
.2,16 , d� "
s.
MM �1 ,�
I
7
rtx e ���, SURVEY OF .,.,
i .9 -< E q o'� o� `s LOT ' 20
m . �o� 0R`� "ELUAAS LANE ESTA TES, SEC 1.
at •A FLED OCT. et 1996 FILE NO. 991:
HI
- . - AT MA T TI TUCK
n , �, - est. TOWN OF SOUTHOLD
ro i CO o SUFFOLK COUNTY, N. 1
y; 'N 1000 — 108 - 04 — P/07.1
of
-,i n - Scale: 1"= 40'
< \
ao , o 0 - Dec. 4, 1356 -
N ,,i 6 h0
7 Cif 'S-% 0 . Z.0 * ,.7 ;ZSr
, 101; c.
(/ !cZ -
c_ �n ' . SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
;1�
® ,�. PERMIT FORAPPROVAL OSS CONSTRUCTION FOR A
SINGLE FAMILY RESIDENCE ONLY
�, Clir't DATE FEB Sara :9T, #�S 1 - ‘2 iao
>�
t1":1�• •N. ; _ APPROVED ��, '
i - . �0• FOR MAXIMUM OF 4 BEDROOMS
o .�`�" - EXPIRES TREE YEARS FROM DATE OF APPROVAL '
•
0 .e 5
0 .
G �, �4z�Qj. �
iff
! o� o
.o0)1/4b.e.f.. `�
tit..-1,:i
.
•'is A VIOLA? N . I am familiar with !hs STANDARDS FOR APPROVAL The locations of wells and cesspools . v-\ 490�d '
' Trow LA�!t...._ iMID CONSTRUCTION OFoSUBSURFAdCE.SEWm V �F50rN�.r shown hereon are from field observations . ' 47,k.1:1114-�;
e.nw `r ` ,F nn4 n,. fp,. .J..l� nh/nl,.A 1�n'4 .+lJt.• `i ' �'