HomeMy WebLinkAboutDoyle JUDITH T.TERRY ;ryes: Town Hall,53095 Main Road
TOWN CLERK k fi� r° '1 , P.O.Box 1179
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0Southold New York 11971
- REGISTRAR OF VITAL STATISTICS ��®�� V,/
Fax Fax(516)765-1823
MARRIAGE OFFICER , ®
RECORDS MANAGEMENT OFFICER �_ � `D �,/ Telephone(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. 3363-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner DOYLE, GREGORY
Mailing Address 1 175 SUMMIT ROAD
Mailing Address 2
City St Zip SOUTHOLD NY 11971-0000
Property Address 1 175 SUMMIT ROAD
Property Address 2
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 516-765-4797
Tax Map No. section 78.00 block 9 lot 9.000
Cross Street SUMMER LANE
Issue Date: 6/28/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK COFO(,�CQ
Town of Southold OHO • G Application No. 6.3Judith T. Terry, Town Clerk . .' y
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Town Hall, 5095 Main Road • a .. � -_ $10.00 - Residential
P. Cs. Box 1179 v' • - ri ;- $25.00 - Non-Residential
Southold, New York 11971 O` 0���
Telephone �l [ `�� ���
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
—
DATE Co -z�/Y-J
OWNER NAME: �� Oe
OWNER MAILING ADDRESS: / 7 S-V _/1-7 /,-„v M
(1oce-f U/ li/ !/27(
OWNER PROPERTY ADDRESS:
OWNER TELEPHONE NUMBER: V( 7 '/7J1' 7
TAX MAP NO. : Section 7 7 Block Lot 7
CROSS STREET: ju
TYPE OF SYSTEM: Septic Tank // New Existing
Cesspool New 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.)
Signature .f Applicant
RECEIVED BY: L'(Jkti
own Clerk's Office
DATE: C,1 /9-r-
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SURVEY OF
LOT / 7 -
MAP OF
"BA YSIDE TERRACE"
FILED MARCH /I, 1953 FILE NO.2034
AT BAY VIEW CERTIFIED TO'
TOWN OF SO U THOL D - RIVERSIDE HOMES INC.
SUFFO.LSK COUNTY N. Y. ,
1000 -- 78 - 09 - 09
Scale I' = 30' '
Nov. 2, 1987
SUFFOLK COUNT'( DEPARTMENT OF HEALTH SERVICES
FOR f F RCVA.L CF CONSTRUCTION ONLY
/
DATE HHS REF. NO. I
APPROVED
\ ..
1 The water supply & sewage disposal sys-
tems for this residence will conform to the
/ standards of the Suffolk County Deport-
ll ' 1-""(5,-N, ment of Health Services.
' ---• .1r° ;1�-� SU ICi NO. 49668
PECONIC 19"VE 'OR '$ E di EERS, P.C. Prepared in accordance with the minimum
($16) 765 . ',••
P.0. BOX .,4"$- B 49°27.:.t/C) /° standards for title surveys as established by
MAIN ROAD QF N Ethe L.I.A.L.S. and approved and adoptea
SOUTHOLD,N.Y. P9771--- for such use by The New York State Land
Title Association.
89 -839