HomeMy WebLinkAboutEckert, James I'O\O'Yf F,,/�'Co
ELIZABETH A. NEVILLE _ '�� Town Hall, 53095 Main Road
TOWN CLERK y P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER `� .j. l��1�, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER � �Ol ��,i� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER •- �
OFFICE OF THE TOWN CLERK
SOUTHOLD 'WJAWIREPATBITEIMPIDSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4094-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner ECKERT, JAMES
Mailing Address 1 P 0 BOX 1160
Mailing Address 2
City St Zip AQUEBOGUE NY 11931-0000
Property Address 1 1635 MEADOW BEACH LANE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 631-722-4766
Tax Map No. section 116.00 block 700 lot 8.000
Cross Street NEW SUFFOLK AVENUE
Lf-Yid
ktio 2Qamidi
Issue Date: 7/20/01 E zabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK �1FF0
� Application No. 7 C9
TOWN OF OOUTBMA ,
I4..IZABETHA.NEVILLE,TOWNCLERK .� $10.00 - Residential �,..
P.O.BOX 1179cr,
SOUTHOLD,NEWYORK11971 �/ $25.00 - Non-Residential
Telephone Sel t $#"/�
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ (0;06
DATE 7,491Q
OWNER NAME: J,4Ne5 C. ,�GbtGT2r
OWNER MAILING ADDRESS: c,a. i.3o X `/4,o
Aque,B q3(
OWNER PROPERTY ADDRESS: 463S- ill t...---TADok.) �c��►C/1 JL4&c
/if i t zX i , N `l 6/ R S's
OWNER TELEPHONE NUMBER: 63( - 7.3a- `1764
TAX MAP NO. : Section/'&,d-</Q.- -a, Block o 7 Lot Icir ® K
CROSS STREET: j() Svr'Fa,c1,c 4 ve
TYPE OF SYSTEM: Septic Tank r/- New ✓ Existing
Cesspool ' New r 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 of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
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THOMAS H.
A UDREY B.
INFORMATION TAKEN FROM:
RANCE RATE MAP No. 36103C0482 G
BASE FLOOD ELEVATIONS DETERMINED
AREAS OF 500-YEAR FLOOD: AREAS OF 100-YEAR FLOOD WITH AVERAGE
DEPTH OF LESS THAN 1 FOOT OR WITH DRAINAGE AREAS LESS THAN
I SQUARE MILE_ AND AREA PROTECTED LEVEES FROM 100-YEAR FLOOD.