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Home My WebLink AboutJanis 11,1` ®Vra ear „-4 V' -, r7i Town Hall, 53095 Main Road = '% P.O. Box 1179 ®� �40, � Southold, New York 11971 JUDITH T.TERRY 7idi'I FAX(516)765-1823 TOWN CLERK TELEPHONE(516)7654801 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. 977-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New Existing X Name Of Owner JANIS, GERALD Mailing Address 1 P O. BOX 749 Mailing Address 2 City St Zip MATTITUCK NY 11952-0000 Property Address 1 JACKSON LANDING Property Address 2 City St Zip MATTITUCK NY 11952-0000 Owner Telephone No. 516-298-5090 Tax Map No. section 106.00 block 9 lot 16.000 Cross Street COX NECK LANE Date Of Last Pump Out 5/00/87 Issue Date: 1/09/89 Judith T. Terry Southold Town Clerk (TOWN SEAL) • if • .... OFFICE OF THE TOWN CLERK Q cvFFO(,- G - Town of Southold CS ; Application No. 9 7 7 Judith T. Terry, Town Clerk �� Y �'� J,i�r t� Residential / Town Hall, 53095 Main Road v ►� cam 1*. P. O. Box 1179 cry '; 4 'fg tri �� Non-Residential Southold, New York 11971 O ` ' Telephone odC `A\\;. • (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 9 17. Fee $ / 0 , DATE A, z6 — g 3' OWNER NAME: `P��0--'6( ( ,s OWNER MAILING ADDRESS: 6 ? ,X o X 2q7 `fes / ecG , //J , X m ;( ' Z OWNER PROPERTY ADDRESS: e-/1-1 v �� k( i Y �?a ThI c It , li OWNER TELEPHONE NUMBER: _ 8-- ,5 C? r2 f. TAX MAP NO. : Section / 6 Block -/ Lot ' 6 (a CROSS STREET: Coy ,2 c Zet..fr7 Cp TYPE OF SYSTEM: Septic Tank / New Existing Cesspool \1/ New Existing Residential Non-Residential DATE OF PREVIOUS PUMP-OUT: _ ) 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.) 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REF.-:. . —--5*C1-71-- / , .-,..:;..: !..;':•,. ,-; ..,,,,.::•,:ii,-6,4v..„„,,vg.,;- ,k4vitr•.;:;,;,4,..,t,,,,;-„,k,Iii..., :I 1. ,,- .4,3•:••:,:, --,‘,.,--...'14:4,,•,-',.::to,„:•:44tf.v-,,:r.:1;•',in'','-, ••' "!, -_,..„.. .. , • ':.;:.;;,-..,•- 's k:;::, :•,,":::• 4:-,,l';',`f•ef I‘',--it,:`,..-1A:a.•-'•..Y.t14'.4.z.,?:-:•;e,,,G.0. -:,)1 1, •• --•i 1.0,:,,• . =•.,•••"-,1-r.N.,•,-S4'.: • ,•- ,, " , -. ,0 . , • ,• . : ,' , - c.,-r,•••• r',:,----.;-: ,`.1'4kTlifi,70. 1.144;54#.1,•tivOUW•Agitt -t,': , ... ,,-,:,-,,-.•:::,,,,,,,.:.4.J,•:.• • 4,,,,,-,„.1.....i',,,--;;,,,,,, .-.0,,,,,,,t,-k-,,,,,,,...... , .- -' - *-,';•'.,.-1.1,i. ..:•''..A.z, ,,,,, The sewage-disposal and water supply , ,'"-, 1 ..',,,-,.,,!,.;,i....,, ,,.•;•„•,,i.,::. ,z,',.•;7,:r.:-..1,z-A-...',..-•:::‘,a,it,,,iliel-1,*;.,C4 '.• ,-;,..,,,-..-‘,..,.. , • -:, •,,•:.••••,..--• •- . -.,-„,,,e,i..-,e,:x.,....tim.T,,,,i0,,,,,,,,:i 4,,,,,,,v; 44.3. • ''• *"*'' .-:,-,'ift."11:2'..t..., ' •-•7;.•. l',''` ' '',,1:---t,i....'.,fat I 1 i t ten.for this location have been •••,' f•-- , % •:•..---:' - ,-' ••-.--P-,'••=.-i'--,,,,•--5APtile;i•---:,?kK•K•t-t•`4:44-:'-'•q ••,: ,„, - „:.•,-:::'•••,,7,--...k.2.- --• ',- '.,'•----e ',•-'-•c •,-41',..., ex-7,1;44.••,,...v .wv-1,,,, ,,..-„ii 04--_,,,7-44r.„Kkv-,4-..., ,.- _,,,,. .,--,,,,,,,,-;,., • , -•/.,,,,,,,,:•• inspected by this department'.and.found 2 '-; .,-•, , '"; n4'„t:-- e•','"',4,-":1..<4-,:t:ti 1---ver-lc,•:Vek'nr414.'?'3'eo`,.''.'40.-:'4,- -,'0, • . , '. .. --• •): —:', ..,,'--,..,.-^,:-.,44,41-.04,41-.T4-,- ,,,,4,1„1,,t•-c,.,,,N1.01, , . ''': 7'----- r ,,:::4,'i,.q„--to be s to .• , . , .. . i *. NL.N. t,..t,...--1-« -r, -4;,% te.,.---.:-t,',- i,y' ••, •'...„..4-'7'i i•--t••-•4.1%-' •k9: '•..: ' - ?' ...' •••- ''':.'V,',.-ti ''. •"- '.--1., t't•-- aftipc .-_, -, , ,:".. ..,: ,,.,..,-......-. -, ,:-,..vt,r6'4!".v-.„11.z.p.;".44;•„,i'',,,Veq,,s1.1.1.':::'04'.10-....,-*.e-"*„.-i, ' -. , .'•''%'1'1'1 V .*--- '.•' ,a•.--. ,...,f:-.7:it,*12:',-N-- --At ' • '; ' ,";.4.!,, . O' ., ,-,'7,:^'''Chief of Ceneral Engineering ,,,,: -- . ' -,••-•...,......,c... ,• , ,, , , •. ' 1 ' ..Unauthorized alteration or addition to-thisiurvey' 'ii'a"-Niolatbrt,pf,,,,,,,' , .. . - . - •-3 ', ,=,..r., .. -- -'•- •' • Send C83 ' ' ,..• section 7209 of the New York State Education Low.:;:.7P,''!'ek-'r-'41 ,:',.... ::.:i.(0.,..,-. • -.. , --, -,,-- •••,- --:::.---.-•-••'• , "':•,.f.: --- .,2 ..!,,;• •• - .• - • r-i-•'' ••• -• • ..