HomeMy WebLinkAboutConnell, Michael o"'� j'
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ELIZABETH A.NEVILLE _ # ; Town Hall, 53095 Main Road
TOWN CLERK o - P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS v' �*r Southold, New York 11971
G �� Fax (631) 765-6145
MARRIAGE OFFICER ?mil, �1
RECORDS MANAGEMENT OFFICER = "'/Q1 4.„,•0 Telephone (631) 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. 4027-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner CONNELL, MICHAEL
Mailing Address 1 715 LIBERTY LANE
Mailing Address 2
City St Zip SOUTHOLD NY 11971-0000
Property Address 1 425 LIBERTY LANE
Property Address 2
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 631-765-2169
Tax Map No. section 79.00 block 6 lot 8.000
Cross Street VICTORIA DIRVE
Issue Date: 6/21/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
•' OFFICE OF THE TOWN CLERK ,�F %
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TOWN OF SOUTHOLD g
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Application No. V0el-7
ELIZABETH A.NEVILLE,TOWN CLERK GN
$10.00 - Residential i__.P.O.BOX 1179 to i
SOUTHOLD,NEWYORK 11971 0 *.$ $25.00 - Non-Residential
Telephone "01 [ �� �1
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERAT ION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE n7, 210
OWNER NAME: f'aCJta.p1 J1oY1ndl
OWNER MAILING ADDRESS: 7/5 j/ bei' �e
5cxdIto lc1, /ly1/' 71
OWNER PROPERTY ADDRESS: l/2`J L,I r / ,C'e
SodcdoZ� N )M7(
OWNER TELEPHONE NUMBER: 765 - 2/(0.9
TAX MAP NO. : Section 7q Block 4, Lot d
CROSS STREET: \/_teJricL, ) V,1 VG
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool 1.,„,- New 1,----' Existing
C?6/
( 3 Residential vNon-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.)
2'1. CA/ (3 , G___".11. '
ignature of A 4icant
RECEIVED BY:
Town Clerk's Office
DATE:
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i _ 0 o Map of Described Property
,' r2 T co z Situated at Bayview, near Southold
0 9. Town of Southold, Suffolk County, New York
i 0 m14 0 m rn District 1000 Section 79 Block 6 Lot 8
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\ Q 2 r Fr ANTHONY ABRUZZO R.L.S.
°� REGISTERED LAND SURVEYOR
g e \ . `i,NEi%'• 10 KREAMER STREET
x .,, � ' BELLPORT, NEW YORK 11713
ii :' . ,1� ,* ' I-.."!:',1
�', 7 • * (516)-286-5383
A -—\ / SURVEYED: July 25. 1999
`� s '..N. LA.0407;., '' iiiorz.own,J.2
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Septic system and w: locations by applicant. Scab: 1" = 30 File No. 236
Elevations are in assumed datum.