Loading...
HomeMy WebLinkAboutJarosz I.0,#ofFO`r0 ®G JUDITH T.TERRY4 Town Hall, 53095 Main Road TOWN CLERK Z P.O. Box 1179 :g6 MARRIAGE OFFICER 0*��► i Southold,New York 11971 REGISTRAR OF VITAL STATISTICS ®� II Fax(516) 765-1823 RECORDS MANAGEMENT OFFICER : Qsijig +.0.6Telephone(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. 3514-R Residential X Non-Residential Fee $ 10.00 New Existing X Name Of Owner JAROSZ, WILLIAM AND PHYLLIS Mailing Address 1 7930 SOUNDVIEW AVENUE Mailing Address 2 City St Zip SOUTHOLD NY 11971-0000 Property Address 1 7930 SOUNDVIEW AVENUE Property Address 2 City St Zip SOUTHOLD NY 11971-0000 Owner Telephone No. 516-765-2202 Tax Map No. section 59.00 block 9 lot 12.000 Cross Street PRIVATE ROAD Issue Date: 9/25/96 Judith T. Terry Southold Town Clerk (TOWN SEAL) OFFICE OF THE TOWN CLERK c3\\FFD(,, - �� Town of Southold �o CSG Application N (i. Judith T. Terry, Town Clerk ^R� � $10.00 — Residential �__ Town Hall, 53095 Main Road P. O. Box 1179 cn st ' �' $25.00 - Non-Residential Southold, New York 11971O ` � �• Telephone _ ( 41 , (516) 765-1801 • TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ DATE 9/2 3 A , D OWNER NAME: T_- ®® 1' ! • ®oS /1" S OWNER MAILING ADDRESS: . A . %` 4 /te. y iffpv OWNER PROPERTY ADDRESS : SA.Ate OWNER TELEPHONE NUMBER: 5.®' a 7e.r®4/2® TAX MAP NO. : Section 5. 9 Block 7 Lot / ;CROSS STREET: ? ,t/4 '/4 iZ _ TYPE OF SYSTEM: Septic Tankj New ' Existing 11•0! 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.) Signet :1-e of A `p i` RECEIVED BY: --• ' Town Clerk's Office DATE: l!'"'• : y i SUPE CO.HEALTH DE�i.'wPPRd7— • •' H.S.•DDO° ;',, u, iggy.rj i • T�'T'� �p • `, .•\•1t AuRi.'• r`Ai. 'f f`,••"-' ° • �'''s Svc'?OLK COUNTY ' D-"2,.., AR.lit iM-' "''' . ..; , 101�,� f���9 j�,+,+p�� �A�l t f i7AeX1J1u. k. A,, •.r ;:. , .:t 4ii�W=,,4 i fit.•. i F y.7�t ti,:4• a. ' J k..ObJ ''1 " M1 `a 1,‘r:;';‘, ;," -r'. ,=,'.t rVL '1' . DAT - __ 1_918'Fi;, D-• iii..: '�� .., -47sev,„,.,,,, r..,,,,_.,,,,,,,:,,,:,, , 3„:„.1 r,„,i,..,,,,,,,is,,,,,,,,,,i,:i 7,,, ,,....,,,... ,, , fac i i-- -i t 1,t i ';rr�'•�- .'' .:• 1yt•' • • '•:.....-;',,' t"" i}t• at nspc,t` -j''t— '•-• ,~,y„o f• y +` { r "'4;I S ' , _ yy ' t I n51 rl II <. AR�y`kyr` y�y�p� 4r f+•'a ij.•,.iJG.n•i'""a.•}°7': s - �'t V=.••,.Y,•.• `1,:,r.: 4�, as`�'>��w 1+ •I/ rf.,, • GPEDL L.f/�O�'L.: 407 S` • 7'Tr ,T.a,•.41 „ •i35 sw + r) � ..,x- . ., : C i ' ' , I, r n� .:L '. 44 •Sa^j' , p'^ .;�. ` r ti" • „.....-„ ,,,-,,,,,,,,,,f.,,,-- ' z ' • "_ ,. - z-,•1 7JJ .' 600.o • r -`".: , ti' _ick.---4:.g-•.: �c r~ •' t •• ' •�.,' r Y�nL• • -I i • 'd,,,:•,-,• 177MJrU#19`C1 /o/ r nf �FF ' aefJ "i, ..•,,,., _ _ '; ,L -'--,-s•-.- g;:,:• , ' r • w$u P?'f.4 4,7 �� r •:'6iw'.�,: •Y^•ct'fi .S.P7 ; ,? j` • • HK ' ..ii` . ,-.',--74I''• '.a ::f' : , • • • ,-tY+ ` .t`% :.*:.;•-',.‘"';-: {:.;•-'PrA. , .t ^ :.,;--..,,,,P. �j „ �+ - .. ' ' t"��• i 'iam••1•.z~s)frl (ac�T= fl ' 1/ � " :� . _!>4r.it,. ' 1 • . ,• . ; /�. • ttli . ' ” .-..1 •••••, ,„ \ ' •• , r . , [ ,, . z . :: • _ -'' ' UNAUTHORIZED ALTERATION OR ADDITION • TQ THIS SURVEY IS A VIOLATION OF ' '' .r' . SECTION 7209 OF THE NEW.YORK STA,TR ' ' _ Sot-- . . EDUCATION LAW. •,>ti ,`., '''",„:1::,^•,e,? `"; ^xl•,+ ,S;;,,,,v°'. '' +,,^ ' • i ,,,;; :COPIES OF THIS SURVEY AAP HOT"BEARING; . w - ;.' 1','•;•'''',..',-,0. "r t.,' ' ' ,, ' ' • • '.; ''i''"•''.-I:; :?- THE LAND SURVEYOR'S INKED,SEAL'OR;,::`•^a."5 -";'r'•t, �•„ EMBOSSED SEAL SHALL NOT BE'CONSIDERED>” ..r TO BE A VALID T7UE COPY ' S "' \ 'IN , .m ,12m'•-— ....:,-.........—;;........1 ' ,GUARANTIES INDICATED HLRLON,SHALL;RUN , , •:f.,,, N-, ONLY TO TEL r. SOr= FOR ViiiiOM THF„SURVEY" D l Ir(�f"i.C9(!LT¢'\ G:�E�I IC"E({{�.. QL .C3" , t •/-igs>I5 PLUMED, A;D ../.•HIS C.-HALF FO THE • i�'" ' ~ ,E `"TITLE COMIfA:Y, GOVLITIVkl-NEAL AGENCY D ",.; - TOWN, , OF , �''y�,• �.�.f lC -.r .77 ", _ LENDiI'G R•5T)IUTION,LISTED H:kEON,AND r„,•`R. '`t , �,�J4..,[ `8i.if- ( ”' 'r, t ��•TO THE ASSIGNEES OF TY,'f"INDING-INS , ,,•• l-h;,,; _ �1� +@ • - 17UTION.GUARANTEES ARE NOT TRANSFERABII ';' �'!•,-�..,,7 y� TO"ADDITIONAL INSTHUTIONS OR SUBSEOUEE,AV f r-+= • - �, 1 - , r -F(rj71 d 9 •/e Wle ,' e , 1WNdMS ., ;Q�`i ,-, ;. .. =y'i , Vit- h :r f `•c,f.. ,Wct tt�^ i�' c m� SIAL',,.x•' -; ". ' ,. - ,' I��� I�K.Li'It" I:�Co c�`Y'' ', --.A� cliere�', �+t' �br�,F' i '�•:,. 5.;,- -. 40 ..chirial a effe' fbi:sva-c ce crr+kitty a* .,v 'Mlar.'. 23,! "T.; ;,; i' SOUTHOLD a$ •- ' ' . -RODERICK VAN 1.TUY1_ P.,C. ,, e..�+,+'�--('1.,it-ivo CQC N 6 e„F, Al. 6 ;v• -•!.,:' . .V,drs.!r!wt� . --i---, ., '.r: .' • ,'�L1C.LAND EUaVEYOPS•GREENPORT.,N.Y. ' ` ,,•'',..,-2i ` e . ,`4+ jif)/04,-i4,- ,�f. w d!+e -.�`:C3 64. i, TERR ..t ik K - T�t - -SUPf.'CO._DEPT.OP HE'At.T1'f'!D$RVIC " _ r$TA ENT°Pim •'1,7,- .5.- 1••,s- , ,v I�`' . . > -, - iy'-• ,=.tr t r Fl ,�{tSJF. i�Vr - .v.''' :V • *0a ,1 PORI`APPROVAL OF`.CONS'�UCTIom-9NIze-.:. ,t:>?:., '„2-:,,s,;.:;.'.f ,- °`'`, "`�' ''a- _.,..... /.4 . s a: •^”, f. .,- -,L-,-...^ ,i,-,;kfi 4',^Yi+�1 r>.•�,I, •',r mss) 69 • rr. ti ,r 'i v4' .';ty .^% D�+,.,r;,';.Sf, f.rw r,�• _C ,",3 �OdM7 .: ''4'',-'1•i-•,,,•.•;,,L-","'f',- ; • -". . ' ,T E WkrT, R ;.SUPPLY ,ANDS SEWAGE ;; " r ` Z.V! ` .' -, , ,)11, xy o f ,,4'.titii,-:r) •J�"t . y.,..,t , _ t.M,_l 1,r .,M •. ^A3.:;. '^;A.':+ t`'''1 DJSPd'SAI ,SYSTEMS:POR.THIS':`TIE 1t `"r "''s • taam 4, :'"'"r,` : 'DEN cE'`'WILL CONFORM';'.re,• TO .THE `. s.i H. EF.. Noel I i `� � W 1, 5'AN 'of SUFE CO:;pEPT 'A' A' rt s< < -•;':7:. 1, „ ,, . t. 'p',yak?tt�,,) } Itid (4-„ '' U"'E: . • OF HEALTH:-sgif7VIGE:..' -. ,, • • 'it.'.. aC '1' .;r, ,t • APPROVED: I :), I- o-d _ k'',:l ' - r 7." .y„+ • ', i;-it I J P-.1=j; ( 'F'' ' P'*' ,.,,,!,4„,,,,...,, -,•••,i,,V •-- ..-.":,- -... — ` -I",--*;.. ;APPLICANT' -i,• ,.. "i.„-'•...ri;:,:;.,••:',:;., ..r..;,4'4:•::•'.....::-: