HomeMy WebLinkAboutLevine ELIZABETH A.NE E _� G'y� Town Hall,53095 Main Road
TOWN CLERK y - P.O. Box 1179
A Southold,New York 11971
REGISTRAR OF VITAL STATISTICS •
MARRIAGE OFFICER Fax(631) 765-6145
RECORDS MANAGEMENT OF ICER y�Ql �aO� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
S UTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4235-R Residential x Non-Residential
Fee $ 10.00 New x Existing
Name Of Owner LEVINE, MELVIN
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Mailing Address 1 201 EAST 79TH STREET, APT 6D
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Mailing Address 2
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City St zip NEW YORK NY 10021-0000
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Property Address 1 710 NAUGLES DRIVE
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Property Address 2
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City St zip MATTITUCK NY 11952-0000
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owner Telephone No. 631-298-5198
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Tax Map No. section 99.00 block 5 lot 12.003
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Cross Street
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Issue Date: 1/28/04 Elizabeth A. Neville
-------- Southold Town Clerk
,
(TOWN SEAL)
I
r '
f OFFICE OF THE TOWN CLERKF
TOWN OF SOUTHOLD ��SU IOG Application No.
ELIZABETH A.NEVILLE,TOWN CLERK �'
P.O.BOX 1179 � $10.00 - Residential
SOUTHOLD,NEW YORK 11971 • $25.00- Non-Residential
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ 10.00
DATE 11/7/03
OWNER NAME: Melvin Levine
OWNER MAILING ADDRESS: 201 East 79th Stree
Apt. 6D NY, NY 10021
OWNER PROPERTY ADDRESS: 710 Naugles Drive
Mattitnck_ NY 11952
OWNER TELEPHONE NUMBER: 9qR 51gR
TAX MAP NO. : Section 99 Block 5 Lot 12.003
CROSS STREET: '
TYPE OF SYSTEM: Septic Tank X New X Existing
Cesspool New Existing
Residential X 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.)
Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
r
SURVEY OF PROpE-RTY
SITUATE: MATI-ITUOK
TOWN: SOUTHOLD N
SUFFOLK COUNTY, NY
5URVEYED: JAN. 12, 2000 W E
AMENDED: MARCH I6, 2000, MARCH 22, 2000,
JULY 27, 2000, NOVEMBER 6, 2000,
1 JULY 50, 2002,
FOUNDATION LOGATION 05-03-03 S
FINAL Oq-Oq-03
SUFFOLK COUNTY TAX # --- ----
1000 - qq - 5 - 12.3
GERTIFIED TO: - tr _z_
MELVIN LEVINE
LILIAN LEVINE
COMMONWEALTH
INSURANCE LAND TITLE
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NOTES: R� : ;I'1r stamped seal shall be consfeerep to be valid true
` npP_
F 1`to -Certlrfcatfons ,ndfca too nerepn stgn Oy that to a. is
_ ��•^�g, ey was preparetl In accordance with the
■ MONUMENT 7 I'' ]1 1 v . t' `v by M1egNewd Yak S[ateof P f Assoc,tce far aan of rProf ess 3onaI
_ �I �^4• Lantl Surveyors Said crrtfricdt Sans sndll rUn only
PIPE �Q 50 o the person wham ene survey is preps etl
f _,and an his behalf to[he title Company, governmen
�`® ���•.�,p a agency no "'a h,
1nst1[ut loo ltstetl Herron entl
aZ.'0i to the a s,gnees or the lentl,ng ,nst,tutfon Cartif,ca
enol trans/crab le to atlaf L,nnal lost llutions
AREA = 313255.F. or 0.72 Acre
Flood Zone Referenced to NOVO ' 2q PoLum JOHN Co EHLERS LAND SURVEYOR
6 EAST MAIN STREET N.Y.S.LIC.NO.50202
GRAPHIG 5GALE 1"= 40' RIVERBEAD,N.Y. 11901
_ � _ �----; ------------- ___-------- _ 369-8288 Fax 369-8287 -_'-_-__----___ _ REF.=TIGER\PROS\99-3 J 2A