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HomeMy WebLinkAboutWilliams -•n o, ��SFFiji JUDITH T.TERRY ,/1_� O% Town Hall, 53095 Main Road TOWN CLERK ; y Z ; P.O.Box 1179 REGISTRAR OF VITAL STATISTICS p '� Southold,New York 11971 MARRIAGE OFFICER =y* O�� FFax(516) 765-1823 RECORDS MANAGEMENT OFFICER : .( * **o." Telephone(516) 765-1800 FREEDOM OF INFORMATION OFFICER .000 , OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 3633-R Residential X Non-Residential Fee $ 10.00 New X Existing Name Of Owner WILLIAMS Mailing Address 1 C/O ELE DEVELOPMENT CORP. Mailing Address 2 P. 0. BOX 1143 City St Zip CUTCHOGUE NY 11935-0000 Property Address 1 1425 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 Li lot 7.035 Cross Street ELIJAH'S LANE Issue Date: 5/15/97 Judith T. Terry Southold Town Clerk (TOWN SEAL) t OFFICE OF THE TOWN CLERK 3 3 �� S\FFacr Town of Southold c ,% C®G Application No. Judith T. Terry, Town Clerk ,:• Town Hall, 53095 Main Road =� $10.00 - Residential P. O. Box 1179 cn •, ; •',;-' Mn ; $25.00 - Non-Residential , Southold, New York 11971 OO: $6 *-4t` Telephone (516) 765-1801 TOWN OF SOUTHOLD • SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ DATE 4111 1 — • OWNER NAME: ► ' 1 2 ►�Yl S OWNER MAILING ADDRESS: 114D-'s C-7 b121 12- M k , N.•1 ( ( 9 OWNER PROPERTY ADDRESS: .IF21-YY1 C. OWNER TELEPHONE NUMBER: TAX MAP NO. : Section IOS Block 14 Lot CROSS STREET: E. l j Ft h Ler e. TYPE OF SYSTEM: Septic Tank New Existing Cesspool New J 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.) / "Dnaturi Applicant RECEIVED BY: Town Clerk's Office DATE: '(,0( v L� � et { \ e v' A Q 2 7F I\ - 266, ' j e p 1J s,. SUR.VFY OF ( x Pr - LOT 11 • Id`a 1s, "ELIJA1IS LANE ESTATES, SECT. 2 z; -o o b - FLED OCT.$ 1996 FILE NO. 9912 s °'' AT MA T Tl TUCK `� f°Pt�• `�� TOWN OF SOUTHOLD G - SUFFOLK COUNTY, N Y. ,\92CD 0 ;- - _ -fJ 1000- 108- 04 -P/O 7.1 - \ y2 r ,mss Scale: 1"= 40' Dec. 4, 1996 - • 26 yy Z r,a /7 R '2S i O o� {O� G 3g 2; SUFFOLK gtR4TN A7:I r CE'HEALTH SZRVICr9 • Sa, -9 • PHUT PCPs APPIIDV L OPO NTRUCr7ON v' R A , �� :mug. PA:.lII.YR'- 'Yo �� DA E FE a•� c t V APP.OV� _ Yui- sE,8�2' ,e . ;' I - l MA;GMI3I+�CP�� 3EDRCOMS• r� h 9�OI�. d u C' WIRES THREE YEARS FROM DATE OF APPROVAL • g 1 �� `so 52�` Q - . 1997 • �,� %o' 0 3� 5 `Q� ` sock co,Dept ci KeaSlt SES \ - a ental Pcateol� - AREA = 40,059 sgft \ . • - - 9 ''� ANY ALTE4.41 CN OR ADOITYNI ro WS SURVEY!S A VIOLATION I am.familiar with the STANDARDS FOR APPROVAL The locations of wells and cesspools ';-. ,-2-1---q=1 ^1 :V OF SECTION 7209 OF rte hE7 YORK STATE MCA nom LA 1, AND CONSTRUCTION OF SUBSURFACE SEWAGE shown ,hereon are from field observation �fyJ Y.S LIG NO. 496!8 ttE N As PV1 SECTION 7209-SLSOMSKINCOF 2 ALL CFRTFI ONLY F DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES and oT from data obtained from others. � "('� ., NERECN ARE VALD FCR A 17€P AND COP ES rt ECF CNL Y F 5CRI1C ci pV SAID MAP CR COPES d£AR 17E/MESSED SEAL OF ThE SURVEYOR and will abide by the conditions set forth therein and on the P / P.C. (1 oto.sE SGVATURE APPEARS hE,?EON, permit`to construct. 't/- �� • ADDITIONALLY TO COAILY 'WTI/SAD LA1 77€ TERM A •.LT&7ED 3Y• 12 • t • ER STREET 441ST 3E USED 3Y ANY AND ALL SURVEYORS UTA/ A COPY 3�A NS ARE REM OF ANOThER SURVEYOR'S MAP. TERUS SUCK AS 74SPECTM•ANOTO AN ASSL7uED CATUK • SOUTHOLD, N.Y. J1977 9ROUGNT-TO-0A78•ARE NOT M CCiPL1AN� IfTT/ ThE LA". , ' 96 - 317 11