HomeMy WebLinkAboutReisenberg, Lloyd s —.— , �oig FO&j'
ELIZABETH A.NEVILLE t1,_� OGy�; Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
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n� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ‘`.°O .F $ Fax(631) 765-6145
MARRIAGE OFFICERy,L
RECORDS MANAGEMENT OFFICER -_"1491 �r'i/�1
Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER _ •0 �
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4028-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner REISENBERG, LLOYD & EDIE
Mailing Address 1 PO BOX 161
Mailing Address 2
City St Zip LAUREL NY 11948-0000
Property Address 1 105 EAGLE NEST COURT
Property Address 2
City St Zip LAUREL NY 11948-0000
Owner Telephone No. 631-298-2686
Tax Map No. section 127.00 block 9 lot 11 .000
Cross Street WHITE EAGLE ROAD
Issue Date: 6/21/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK COF L/
` � s
TOWN OF SOUTHOLD pP A Iiisation No. '7625
FrLIZABETHA.IVEVILLE,T WN CLERK $10.00 - Residential
P.O.BOX 1179
ct, $25.00 - Non-residential
SOUTHOLD,NEW YORK 11971 rp, ";
•
TelephoneOj �NO-°@
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
•
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE 6/149_00 0
OWNER NAME: L1. 0 �
Ee-\5'.l, beYl
OWNER MAILING ADDRESS: ?O. 6o 16(
L d,0 v- J i\) l Ng?'
OWNER PROPERTY ADDRESS: 10 Ec J\e- Cactri'
LcA,0 rel ►i
OWNER TELEPHONE NUMBER: D-P(g'
TAX MAP NO. : Section (000 Block - 09 Lot
CROSS STREET: LJ ki fe. E a.g1e Rdl.
TYPE OF SYSTEM: Septic Tank ✓ New V Existing
Cesspool New Existing
Residential ti 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 Appy
RECEIVED BY:
Town Cle k's Office
DATE: 6 / 2 C)
scows REF. # R1"-99-0084
SURVEY OF PROPERTY
° '�l AT LAUREL
TOWN OF SOUTHOLD
SUFFOLK COUNTY , N. Y.
'11. ,Y'
1000• 127-09-11
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4 S�esl 1.440'
Y 4-c.f.''4• 10). SAPPRIL I Sr 1999
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S MAY 15, 2000 ( 0nd 1
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i om fa'act with the STANDARDS FOR APPROVAL + \P - L. ll4 fJ
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AND CONSTRUCTION OF SUBSURFACE SEWAGE1
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DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES le •
and*NI abide by the conditions set forth therein �W
and on the permit to construct. '
The Iocotions of.alfa and cesspools 3r.,shove hereon or. from field obserootions S '..22...
and or doto obtained from others. i. IA �
Lot numbers refer to 'Golden View Office , •�K
Toed in the Suffolk County Clerk's 051ke on tt
Auqust 30. 1984 os File No 7770. 14t,
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Elevations ore referenced to an assumed datum. - II IP
eel 1, �.I� '• `-- ,fi $e
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CERTIFIED Tet • 4 +#�¢
Loyd H. RnbenDerq . . GQ
Edie H. Rebenberg
Fidelity National TNN Insurance Company of New York
%1..:(44)
��i �`± - tEOF NEW.
,, S�p,N1.MF�jQj04:fi.
AREA = 40,368 sq. ft. •'s• � �� ''9
"F� /y� .ii.,-„., Y. *L . NO. 49618
l�� mile.'
x114" '
ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION ►•Ilt �t`-
OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW.
#141 'ECO S •°�
f EXCEPT AS PER SECTION 7209-SUBDIVISION 2 ALL CERTIFICATIONS - (q3/ ) k;' 'qa 5.200 F iQ •3/1 765 - 1797 •
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF M ,y° P. Q. , a 4q6\ ��
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1 �- st 1230 TR''`'' Ai% " �/ ry
WHOSE SIGNATURE APPEARS HEREON �\ o? SOU THOLD.. `. -. 11971 99- / / t✓
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