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Town Hall, 53095 Main Road
�� P.O. Box 1179
c*V-••'Ole Southold, New York 11971
JUDITH T.TERRY ®1 TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 673-R Residential X Non-Residential
Fee $ 10. 00 Septic Cesspool X
New X Existing
Name Of Owner DIRR, FRANK J. & BARBARA M.
Mailing Address 1 299 FIFTH STREET
City St Zip EAST NORTHPORT NY 11731-0000
Property Address 1 845 RYDER FARM LAND
City St Zip ORIENT NY 11957-0000
Owner Telephone No. 516-266-3577
Tax Map No. section 15. 00 block 4 lot 7. 000
Cross Street PARKVIEW LANE/UHL LANE
Date Of Last Pump Out 0/00/00
Issue Date: 4/27/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK %I Mite- 75
Town of Southold �� CQG' Application No.
Judith T. Terry, Town Clerk •
-r Town Hall, 53095 Main Road ` Residential
P. O. Box 1179 " ` rF. �`'. Non-Residential
Southold, New York 11971 Ohio �����•`
Telephone •
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
•
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE 54-74
OWNER NAME: /�e,4Ai > %J /1-i?6/1-RA M. /
OWNER MAILING ADDRESS: .299 57-" sr. -
L�ST A/o/ 7-1- p®,e7-) Al,)/. //731
OWNER PROPERTY ADDRESS: S'46 gy1sCr{ /%A�2wt �AfiJ
ogle,J 5 Azy 11967
OWNER TELEPHONE NUMBER: -616 - "3577
TAX MAP NO. : Section /.. Block `T` Lot 7
CROSS STREETO 704-i2/C i , u/ Z•4i✓E / U�L L,4"Nt�
TYPE OF SYSTEM: Septic Tank )( New //3( Existing
Cesspools x6:1) New X Existing
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT:
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.)
Signatur o Applicant
RECEIVED BY:
Town O'Ierk's ffice
RECEIVED
DATE:
APR 27191313
Town Clerk Southold
4,' ' y 'y Aa.
I LOT 59 �
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LOT 61
SANE
VIEW .1,":)-..-. .,
PARK
CERTIFIED TO:
MAP OF COMMONWEALTH LAND TITLE
INSURANCE COMPANY .R
LOT 60 TITLE NO. G-620-1795 .
FRANK J. D/R R a BARBARA M.
'ORIENT BY THE SEA ' DIRR, UX
SEC TION TWO
AT ORIENT PO/NT
ELEVATIONS ARE REFERENCED TO AN
TOWN OF SOUTHOLD ASSUMED DATUM
SUFFOLK CO. N.Y. •
donack associates
F/LED OCT. 26,/96/ FILE A/0.3444
313 west main street
oq, _ riverhead ,new york 11901
. (516) 369- 1717 •
ar DEC. 9, 1983 •-- Job No. 83-395
1000-015-04-07 Scale : I"= 30'
FOUR MONUMENTS PLACED ✓A N. /6, /984
FND.LOC.—4-27-87