HomeMy WebLinkAboutHoust JUDITH T.TERRY ; ,-¢ V ` % Town Hall,53095 Main Road
TOWN CLERK � P.O.Box 1179
REGISTRAR OF VITAL STATISTICS 0Southold,New York 11971
MARRIAGE OFFICER =412 ®�I/ Fax(516)765-1823
RECORDS MANAGEMENT OFFICER : ®I �a •1 � Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER ,,s•'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3370-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner HOUST, JOHN P.
Mailing Address 1 P. O. BOX 583
Mailing Address 2
City St Zip LAUREL NY 11948-0000
Property Address 1 1545 PECONIC BAY BLVD.
Property Address 2
City St Zip LAUREL NY 11948-0000
Owner Telephone No. 516-298-0138 /L778
/8 1 l '- 3-3
Tax Map No. section .00 block mot `2--OO
Cross Street WICKHAM AVENUE
Issue Date: 7/28/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFIC,.E OF'THE TOWN CLERK s��FFOUr:
Town of Southold � CQ t� Application No.
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road - $10.00 - Residential
p. O. Box 1179 to $25.00 - Non-Residential
Southold, New York 11971 OLO
Telephone ,( * •
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •, -
DATE 7))0)9
OWNER NAME: 10 -US P D 45-r
OWNER MAILING ADDRESS: P b )C cj$3
L! PLe L. J (J 1/99
OWNER PROPERTY ADDRESS: )s-t4 l� 1, 6LIL.O
Lo( 2ek_ i Y 11 y8
OWNER TELEPHONE NUMBER: ,5-110 pZ% 8 0 i 3 8
TAX MAP NO. : Section l 9 Block i Lot 3
CROSS STREET: Alb its 04Ktilisk0 IAD
TYPE OF SYSTEM: Septic Tank New Existing /
Cesspool - t/ New Existing +7
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.)
P,
Signature of Applicant
RECEIVED -BY:
Town Clerk's Office -
DATE:
J
26
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, ,NAuIHORIZED,AIIERAIION OR AUOIIK,r Q01�
TO THIS SURVEY IS A VIOLATION OF G
N\ „k��,ry
SECTION 7209 OF THE NEW YORK STATE O pie
EDUCATION LAW, ? E;3y
COPIES OF THIS SURVEY MA9 NOT BEARING Oje°e0d
THE LAND ;UPV(YOP'S INK,0 SEAL OR
:MBOSSED SEAL SHALL N.'I RE Cc) I0ERF0
TO BE A VALID TAUS COPY .. SF,
0
i UARANTELS INCICAT,L, HLREON SHALL RUN Uk`T14i P SURVEY FOR
DNLY TO THE PL.:SON FOR WIK)M THE SURVEI /'
IS PRTFARTD, AND C,I HIS KHALI TO THE JOHN P. ROUST
• TITLE COMPANY, GOVER:r,,,;HAL AGENCY AK " MAP OF LAU REL PARK II LOT NO. 25
.ENDING INSTITUTION LI,IcIi h LION, AND
'O THE ASSIGt iS OF ha I?1J'E-G INTI• 'k-gi,b ....:qt
'UTION GUARANTtFS A.tE t,01 E .. LAUREL .��' `°'•'
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0 AL ,HI-)NA „ .,.,. ..,< ,..,.,� TOWN OF SOUTHOLD {r�'�r�a v y,�•'•�,I„ ,�.
SUFF. CO., N.Y. CERT IFI
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ARCS RT OE i+ Ihfl ; `
TICOR IR? E OP.ARA
NOTE:• - MONUMENT SCALE: 11I = 401 YOUNG a i G � '^'::1'1.fix1,ti1' ,
SUBDIVISION MAP FILED IN THE OFFICE OF JAN. 9 1992 t ''``" '''`'""
THE CLERK OF SUFFOLK COUNTY ON a.0,2, .,J-o„'., a
OCT. 5, 1925, AS MAP NO. 212. PROFESS yEERttD,'
SUFFOLK COUNTY TAX MAP
LAN D SUR '• .' ,., .YDS. C?N0. 12845
' = DIST 1000 SECT 145 BLK I LOT 3 R IVERHEAD, N�.'Y.,,,, T c• ' ,
' JOB NO: 92-0007