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HomeMy WebLinkAboutDwyer 1 ' dd Fes'41'C E r �I. Town Hall, 53095 Main Road . �� P.O. Box 1179 S__ l Southold, New York 11971 JUDITH T.TERRY = �� FAX(516)765-1823 TELEPHONE(516)765-1801 TOWN CLERK 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. 1157-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New X Existing Name Of Owner DWYER, REGINA Mailing Address 1 1240 WEST ROAD Mailing Address 2 City St Zip CUTCHOGUE NY 11935-0000 Property Address 1 840 BRIDLE LANE Property Address 2 City St Zip CUTCHOGUE NY 11935-0000 Owner Telephone No. 516-734-7475 Tax Map No. section 102.00 block 8 lot 16.000 Cross Street HIGHLAND ROAD Date Of Last Pump Out 0/00/00 Issue Date: 6/16/89 Judith T. Terry Southold Town Clerk (TOWN SEAL) S. IIS OFFICE OF THE TOWN CLERK ���FFD(�.�I 1. - Town of Southold �\� �Q - Application No. /16-7 Judith T. Terry, Town Clerk . 1A, '• Town Hall, 53095 Main Road cr :G l Residential P. O. Box 1179 - ; ,,, Non-Residential Southold, New York 11971 O ®t �� Telephone : .( 0‘.. (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. /(`-/-7 Fee $ /6 — DATE ,/ / '( ? OWNER NAME: &3mfla. i bUJ )/ r1 OWNER MAILING ADDRESS: l go L' �',s f 6 ,UAe.L1aoL,4, , i) ./ . ! I ,, , S OWNER PROPERTY ADDRESS: D 61-i C7 lPl-Yre. 0 L.) ii-c,ii-c,/IA j 0 p 1 r k-I / � ( t '1 3 .S.-- OWNER OWNER TELEPHONE NUMBER: 73V- 7 v75 TAX MAP NO. : Section /6.:2-- Block 9 Lot CROSS STREET: . h (a !'l � . JQ TYPE OF SYSTEM: Septic Tank (i1j1/11 )-- ,New J Existing Cesspool New Existing Residential Non-Residential DATE OF PREVIOUS PUMP-OUT: /9- 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.) 11.10 .. . ► .! < ,, 1` .dr% or'gnature of Appliot RECEIVED BY: .. Towr( Clerk Office (� //c1/4-7//c1/4-7C � �® DATE: J1 UN 1 C 19b:i ygo ut 132422 r vs,4 ------- ) a 31-- 71 ----, 2 / i/ 1 , i , / i 1 r i , X Wc-'• ' &t , , , , _ --,„ . . ....._ < / if- A .., ,_ (-.) to f', 1 \ \ \ i i I I ' , 27 _------___ _ 8 r-i cli le: L ._ _. N.! " '''' •,,,.4,4 • ki-.......__-, ,_• ::„, _-_--. _._1.,„:,z, 2-:,-;,.,,,,,, , _ \"1/4 j 0o1 ,\/ ,,,:„.,, . . _,, . . , EP. 6\0• . . , , 1 - 1 , , '5 0,41. • r 1,, x- t h`�0 ,`�,` 5 :e;Ff7.,:v6A' ari" � 1) . ., „,--_,,= _.2.. 77) F J PG P14 :i i.`% /\ i .. s '. 'c)0° - . \ / < O., 40,0E- > '' "1 1`.; -..' di" \ el' V \ IL \ N%; 17 T. \Z 1. I ..,11 ♦ \ 0. S (1, ,-5,,e ,,) > \•`, \() ‘d - / �� Af—`9 / / ssi. 1 \\�p� \ \ 37'0 - f- 34• :(j� \!"fin N --; )di .\ .,..:, \...\.. . '\s" *,. \ ., \ ' -P •-a• -i - i o s�, t ��-' 4;,./ \ DWELLNG 100 +II �'� } , NN:\NN\. . ,' . • • Lt) M1i, za`�.`JCL y ;., s - - - ‘ Dc\.* - • 1 ' `'°`1...,..;t=: apt rs' !" 2. �� O5_ °- ; �pp�-- I' � f + r '}4+ , - ,..'f.'":',-V-. +,r;1', �l . \ - �1��• 5.,.- _ - -....-..,..",1:,,'.- - 1i i-'^_v`N•_v,-'��-Ii Y' '-e _ ' }r• - ,t\ _ /� i- -r - , {ti -r '`'`> rKJP zr�,` :`,�--s ;:: r --i. - .•i;,_ • -epi)' - - _'�,-. - _ •� _ - _ • V :?.ir' - .$r+ ;:j'-;.:- ", .,, - t•'• +`7 - -t - t/ _ , . ?'''-4i a-',_;L� .1...i. L.x.':•= ,R �t s.' � fid:;,-:, 'rr - • - • ''li% • • i.i,.% Ott,;,. - -.y>.,s .`d'cr�,�3'"1.1,-..,;.,,- - '},I •l '1" ,,Nf 1 .1l'•+ r • Y.. - - ^'j - �e- i�4 � .•3`^: _- ;�'rt `•M - -v,€';._tic^ <:K•, S - ;4, c 7 .r.• „,1,4--",.:4,-; 'J, -t - 't,, •1 a, .rte' .-•Kc. `-l� y' - - ic.:2 ,mss.•iy.- :d{-� y t`,• •-s'�- : o ' r. 'i •5�• rf•avo-i - :4- µV,n .tr - - +`•ter'”- '-F�'r'' - _ t.` is-'''L•. . 1 1` ,Iff, �1. `•15'f- J1'' - ( ', \ A j. - - i ria•� �1- t' '� � � `i� �i- jjII (./�+'�+t ,�_rY;dlrF"I� � ti � ..,. ., � j •� .i" = • r, I,L• "1^f•�1:f�rn ,3„ •v.rf,lGl•1�''I` "J i qV• U , O , . ,l•�, s,'� �,,r"- ,,n' ,�