HomeMy WebLinkAboutDana JUDITH T.TERRY Town Hall,53095 Main Road
TOWN CLERK P.O.Box 1179
REGISTRAR OF VITAL STATISTICS VO 'W , Southold,New York 11971
MARRIAGE OFFICER 44 � 1.9 Fax(516)765-1823
RECORDS MANAGEMENT OFFICER � `ms' ��� 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. 3297-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner DANA, WILLIAM
Mailing Address 1 WATCH HILL REALTY 8 DEVELOP.
Mailing Address 2 958 SUNRISE HIGHWAY
City St Zip BABYLON NY 117011.-0000
Property Address 1 6960 SOUND AVENUE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-669-4010
Tax Map No. section 121 .00 block 5 lot 1 .002
Cross Street COX NECK ROAD
Issue Date: 12/22/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
%FFICE OF THE TOWN CLERK S\\FFO(,r�
Town of Southold o c 3 02"
Judith T. Terry, Town Clerk ��r �� Application No.
Town Hall, 53095 Main Road -< $10.00 - Residential -"/P. 0. Box 1179 crs h�i " $25.00 - Non-Residential
Southold, New York 11971 %30—
Telephone
Telephone c ( *0
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(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE / 4.2/9 Y
OWNER NAME: UM-61404 Pilil/}70/ eq Foci izot y�t f/ 0 W CO2,,
OWNER MAILING ADDRESS: IlF-S8 _SvV'- SL Kb'J 7
8,46yc-onJ A/�, i Yatti « 7O4
OWNER PROPERTY ADDRESS: ‘P6.0 SOci v". 4-riJ/✓vE
-747-77 r r/e/C f91/Cu/ KOrllC -
OWNER TELEPHONE NUMBER: (37 ) V0/0
TAX MAP NO. : Section '2 Block Lot 4 a
CROSS STREET: r' X Ne ,)
TYPE OF SYSTEM: Septic Tank ✓ New ✓ Existing
Cesspool ✓ New r 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.)
(./(Le
Signature of Applicant
RECEIVED BY: ?7�
Tow= Office
DATE: ✓ D2L.5174Y
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•NOV 2s 1994
•
: SC.WEALTH SP1. OF
ICfS
SURVEY FOR
WILLIAM• DANA a WATCH HILL REALTY ' •
DEVELOPMENT CORP. OCT_ 13,1994
1992
AT MATTITUCK - DATE MAY 28,1992
TOWN OF SOUTHOLD SCALE I"=too'
•
SUFFOLK COUNTY, NEW YORK NO 92-0437
*UNAUTHORIZED ALTERATION OR ADDITION TO THIS
SURVEY ISA VIOLATION OF SECTION 7209 OF THE
NEW YORK STATE EDUCATION LAW ��NEW
*COPIES OF THIS SURVEY NOT BEARING THE LAND S.
IVL
SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL ` W 0 .-
NOT BE CONSIDERED TO BE A VALID TRUE COPY
R GUARANTEES INDICATED HEREON SHALL RUN ONLY TO �� .r yOG
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE PERSON FOR WHOM THE SUMEY IS PREPARED .. SAO
AND ON MIS BEHALF TO THE TITLE COMPANY,GOVERN- y 0 ay
- N NEAREST WATER BAIN—MIS *SOURCE OF WATER+PRIVATE_PUBLIC MENTAL AGENCY AND LENDING INSTITUTION LISTED '' = ~r:1141j
N SWF CO TAX MAP DIST 1030 SECTION 121 BLOCK S LOT J. HEREON,AND TO THE ASSIGNEES OF THE LENDING 419r( 'IIC`'
LATHER[ ARE NO DWELLINGS WITHIN 100 FEET OF TINS PROPERTY INSTITUTION GUARANTEES ARE NOT TRANSFERABLE , ► rIl•
-• OTHER THAN THOSE SHOWN HEREON TO ADOITIONAL INSTITUTIONS OR SUBSEQUENT
_ M THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE OWNERS Ve, O
WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY *DISTANCES SHOWN HEREON FROM PROPERTY LINES s> • ,'8'
Of HEALTH SERVICES. _ TO EXISTING STRUCTURES E FOR A SPECIFIC• SH '
M
ARUCMT PROPERTY LINESPURPOSE AND ROR FORE NOT TTHEO EERECTION USED TO EOP FENCES °��`0 L Vii S `
ADORESS
e
TEL E. YOUNG a YOUNG 4ANDER AVENUE
RIVERHEVERHEAD,NEW YORK
„�- NOTE ■=MONUMENT 6,.STAKE 0=IRON PIPEy ALDEN W.YOUNG,PROFESSIONAL ENGINEER
AND LAND SURVEYOR N.Y.S.UCENSE*0.12845
IT
- ■MLOCATKSIOFWILuwI,SEPTIC TANKtSTINCEiIMOIs(a)SHOWN HUEDM HOWARD W.YOUNG, LAND SURVEYOR ,
N.Y.S.LICENSE NO.45893
°= ME PROM FIELD OBSERVATIONS MOOR DATA OBTYMED FROM OTHERS
9RANDIS A SONS IND. . -
RN