HomeMy WebLinkAboutHamma ' � �,�► Town Hall, 53095 Main Road
P.O. Box 1179
NA! l� Southold, New76501823 rk 11971
JUDITH T.TERRY
TOWN CLERK CLERK TELEPHONE(516)765-1801
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. 1161-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner HAMMA, ELIZABETH
Mailing Address 1 P. O. BOX 1038
Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
Property Address 1 765 CEDAR DRIVE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-4764
Tax Map No. section 106.00 block 11 lot 8.000
Cross Street BAY VIEW ROAD
Date Of Last Pump Out 0/00/00
Issue Date: 6/16/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
// ,i'
OFFICE OF THE TOWN CLERK ��FFli(f, -- r
Town of Southold A - _ Application No. /1
Judith T. Terry, Town Clerk .r.:47 Ylify
Town Hall, 53095 Main Road Residential k/
��
Cf7 � :r
P. O. Box 1179 ��..= .-r. �i Non-Residential
Southold, New York 11971 O ® _.,. 0 °�`
Telephone
Q(
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ --
DATE ,t,, uz
OWNER NAME: ��y7_c,k. � A a \AA VIN_A ,
OWNER k,-r.'rING ADDRESS: Lo.Z \-)r •
OWNER P-R- -P-ER-T-Y ADDRESS: Q D\(
OWNER TELEPHONE NUMBER: IC,* - � 6 +
i
TAX MAP NO. : Section 1 0 , 1 Block Lot F
CROSS STREET: -V") �, \I \
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential ✓ Non-Residential
DATE OF PREVIOUS PUMP-OUT: 2 — V.ii-c (Lse . 1W1
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.)
i
skip,nature. of App icant
RECEIVED BY: •
Town Clerk's Office
DATE:
A,/ /__: j "(, -
/ ,
I `y.
Bq y VE/ W ,
4VE.
6 ""\
_ LOT �_ .
31ci
,y3 O r • (,)
100 OPD V:
MON
0 50
N ? rJ
y "o Z
o
52 007 too" E*
,, 5 0
N• - o
R
Mo2 w 32 (s)
N � Z-3-
,
Z corp STOOP -
W
24 2 n m
v �, w t_
0 623' ,� _
C) '' 6A STOP STY' m . 'L51.. PA_
S "1 w a
FRN --------
til
--`
m �,
O 'v- NSE ' ^ 4 (,)
1 . /"� 24 2, 3 3 `y1 o
TOm 1
o
�
i �� O, i
M m Or)
n CONG 6 LKWU.S
A RErA�N'N 111 \'''t-
vQD
, 0.00 ,I 3
0
0
o
m
FND MON o 07 ,OO"i �/
5.52 3 4
L0T ,lEOFNE4, ,
CO 0_,0\N. O o,, Q,�,
( � °.1-.
")Ls, �°= 49263v J��0 .
• ZLAND S/
CERTIFIED TO:
EMPIRE OF AMER/CA
COMMONWEALTH LAND TITLE
LOTS 32 8 33 INSURANCE CO.
MAP OF ROBE1RT J. A MAR/ON W/N/FRED
SLATER
"MATT/TUCK DEVELOP/NG CO., %NC "
IFC
F/LED MAY /,/923 / FILE N2776 donack associates
AT MATT/TUCK 313 west main street
TOWN OF SOUTHOLD riverhead , new york 11901
SUFFOLK CO, N. Y.
(516) 369-1717 (212) 746-3020
July 26, 1963 Job N2 83-313
1000- 106-11-08S col- 1 = 30'