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HomeMy WebLinkAboutDunne OF SO!/r�®! ELIZABETH A.NEVILLE '` O Town Hall, 53095 Main Road TOWN CLERK #[ #[ P.O.Box 1179 REGISTRAR OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER a� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER ®ly Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER COU IY 1 a,� southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 4295-R Residential X Non-Residential Fee $ 10.00 New X Existing Name Of Owner DONNE, STEVE --- -------------------------- Mailing Address 1 1210 TUTHILL ROAD ------------------------------ Mailing Address 2 - ---------------------------- City St Zip SOUTHOLD NY 11971-0000 -------------------- -- ---------- Property Address 1 1465 HILLCREST DRIVE ------------------------------ Property Address 2 ------------------------------ City St Zip ORIENT NY 11957-0000 -------------------- -- ---------- Owner Telephone No. 000-000-0000 ------------ Tax Map No. section 30.00 block 2 lot 80.011 Cross Street HEATH DRIVE ------------------------------ ------------------------------- -- Issue --------------------------------------------------------------- Issue Date: 10/20/05 Elizabeth A. Neville -------- Southold Town Clerk (TOWN SEAL) ELIZABETH A.NEVILLE Ca Town Hall,53095 Main Road TOWN CLERK to Z P.O.Box 1179 REGISTRAR,OF VITAL STATISTICSO Southold,New York 11971 MARRIAGE OFFICER y • �� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER ��l `�►aO Telephone'(631) 765-1800 FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net -OFFICE OF THE TOWN CLERK tv2 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISTRICT APPLICATION -- OPERATION PERMIT- CESSPOOL or SEPTIC TANK " Residential @$10 V'or Non-Residential @$25 Application No. L4/2 Permit No. oZ Owner Name N a 0— Owner Mailing Address I A/b "1'`cl41%1 r ev Owner Property Address 4 (o 57 )M [ �- © tz I l R dz- Owner Telephone No., Tax Map,No: i Section Block 2 Lot • 4 j Cross Street Please check each that applies: New Construction Alteration to Existing System. Residential Non-Residential ' NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. (Locate building and system; give north arrow and approximate distance in feet from system to building and closest road. New construction may sub it copy of � ey with SCHD approval.) Si a 'e o ppscant Date Received by: ►� SCDHS REF. # RIO-03-0132 / bm 14millar with The STANDARDS FOR APPROVAL ` AND CONSTRUCTION OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES D�ELC/NG and will abide by the conditions set forth therein and on the *4Z4 a + permil to construct. OV� iso. UR VE Y OF S �e � ,so * LOT 9 &' S o3 ReS7-¢a ',sO"� s SUBDIVISION MAP OF '��AR EST �A`� _Ei HIL L CRSS T ES TA TES SEC TION 1 3/, tl1� �R��/c ba* e g �� �/` FILED AUG. 15, 1983 FILE k0. 7218 150.00, AT ORIENT TO WN OF S OUTHOL D SUFFOLK COUNTY, N. Y. 125 1000 1000 - 13 - 02 - 8. 11 2 srr rR 4 c� Scale 1" = 40' R GARffSE 1 3� A ug. 25, 1988 ;� zos•' r .,� ca. Opp SEPT. 4, 2003 (B.O.I�I INFO. 1 as,. Y R " 25'�� pg (New 44's E-) 3g. FEB. l4, 205 ( CONC. FOUND. ) 10 i 4, zs HSS C� AUG. 30, 2005 (FINAL) 0l0' G,qR" 3 ,• i ^` OCT. 4, 2005 (FINAL) p. , a �� CVN 4 0 V co 55 I / ANY AL TERA TION OR ADDITION TO THIS SURVEY 1S A VIOLA TION / OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. O EXCEPT AS PER SECTION 7209 - SUBDIVISION 2. ALL CERTIFICATIONS (V HEREON ARE VALID FOR TM MAP AND COPIES THEREOF ONLY IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR KE[4 WHOSE SIGNATURE APPEARS HEREON. The locations Of wells and cesspools ADDITIONALLY TO COALY WITH SAID LAW TERM 'ALTERED 8Y MUST BE USED BY ANY AND ALL SURVEYORS UTILIZJNG A COPY N 0 shown hereon -are front field observations OF ANOTHER SURVEYOR'S MAP. TERMs SUCH ,(MSPECTED 'AND and Or from data obtained from others. 'BROUGHT - TO - DATE 'ARE NOT IJV C CE WITH THE LAW. OF NEW Yoji r _ WELL A i co rc� 75p p0, O CER TIFIED TO, °s B z�O m FIDELITY NATIONAL TITLE ' RO WV-- N o kt zAe INSURANCE COMPANY OF NEW YORK C . 496/8 S HSL SD" W S ' RGO BANK N.A. A FRANK J.WELLS AAND MARIA CASELLA PECONIC ..6 R 04 �P6 (631) 765 - 50 65 - l 797 Q 1'P,Q�VA 1E Ez 2�a 4r AREA = 40,050s .ft. P. 0. Box 909 ELEVATIONS ARE-REFERENCED,-AR,� R�ADJ 1230 TRAVELER STREET TO AN ASSUMED DATUM.- SOUTHOLD, N.Y. 1/971 i 88 - S_�n