HomeMy WebLinkAboutJessup JUDITH T. TERRY ' c Town Hall, 53095 Main Road
TOWN CLERK 1=,1
P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER ® O 'i�. Fax (516) 765-1823
\-74'0 ��® �! Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 1848-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner JESSUP, JOHN J. AND ETHEL L.
Mailing Address 1 P. O. BOX 419
Mailing Address 2
City St Zip CUTCHOGUE NY 11935-0000
Property Address 1 EAST ROAD
Property Address 2
City St Zip CUTCHOGUE NY 11935-0000
Owner Telephone No. 516-734-5313
Tax Map No. section 110.00 block 7 lot 15.000
Cross Street PEQUASH AVENUE
Date Of Last Pump Out 0/00/00
__ --�,, '_ ° ✓mac% ""' . - ...
Issue Date: 2/14/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE,,DF THE TOWN CLERK ��
`"-Tow'n of Southold �� CQG' , Application No.
Judith T. Terry, Town Clerk , : ?
53095 Main Road - $10.00 — Residential ✓
Town Hall, � �.>- ,• r
P. O. Box 1179 cn 44;..1'z ,
$25.00 - Non-Residential
Southold, New York 11971 O �
Telephone _ / _
(516) 765-180,1 1
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or. CESSPOOL
Operation Permit No. _
Fee $ /0. 00
DATE - 02 -7,e
OWNER NAME: TOy4/ v- &H/. 2 0 cJ�8,5i P
OWNER MAILING ADDRESS: ?D. ,(3.0 )e. 4/ 1
e U r e iv o v im , `. �/. 117 35'
OWNER PROPERTY ADDRESS: E/93-7- RO . /
d 7-a wo c- 11e-; N.V. I / ,,35_
OWNER TELEPHONE NUMBER: (j4) 73_ 5d /3
TAX MAP NO. : Section //a Block 7 Lot 45-
CROSS STREET: - Pf 1Jj4$ 1f )9 v
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool V/ New Existing
Residential V Non-Residential
DATE OF PREVIOUS PUMP-OUT: /ti'oA/,5-
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.)
cy/Fivi,L,
de%ee- a
Signature Appli nt
RECEIVED BY:
RE f Ierk's Office
DATE: FEB 14
Town Clerk Southold •
-' _ - ,.. .. _ _ �' - -t r%:t.�,f:_.^`'-�ss 1..: -i •-- _•_�- _- / -..-_-. -{-.wq —_ ter•.+• - __ _ _
-t
�'t..:z�;�, t,11-'..":.k d.� K: I- t I �"� �I _
CI Jr1 s
NI1 m i, I;
, i
a • -;
-
, • „2 - . I
j
!
• { i,•
J t
1 f ,,
r �� V.ii.n.1 ,Dr-"-- L._ is ;
s M' k �' •
SUI: -? !_£ FC?
- 2t �� /�`
y r, 1,
' ,t7 I /,F yJ 4/
`
•
•
C4.7-Cr .C. _ L-r s .,
s if
C�'v•;ins ' >L ��HQLD �`:i • i}�
1 � ��ITC. /
X�f � � -Pl r�I
a
SrC i lli t�� i
t 'x !; ' 3 i I ' L
UNAUTHORIZED ALTERATION OR ADDITION 9
'Lt TO THIS SURVEY IS A VIOLATION OF , •
O - 0SECTION 7209 OF THE NEW YORK STATE a Cr "� �"'+--k'+I,kt 1 t'*�' f f
1 /Q EDUCATION LAW,
} �,
COPIES OF THIS SURVEY MAP NOT REARING
Z _ _ __ -- ; THE LAND SURVEYOR'S INKED SEAL OR _ _- s, i
I - `V� EMBOSSED SEAL SHALL NOT BE CONSIDERED
`j �{_ TO BE A VALID iF.UE COPY.
.,s —
• r�,,,,•••••,...,„.....- ! F' GUARANTEES-INDICATED HEREON SHALL RUN ;
4 --� , � t (/f ONLY TO THE PERSON FOR WHOM THE SURYEY
..77.40z----,--,.._,„ - '-,.J =.�;.` ;.ar" - `• _ �' i IS PREFACED, AND ON HIS BEHALF TO THE - G IdY.:Irt-4 eye 6 i U -4='t -_CF''lC::.xti •,: i,f,
w 7,-----x.-...___
- ti _ '�. + _' _• TITLE COMPANY, GOVERNMENTAL AGENCY ANT) I 1 4-le 111 5 L1 Y LJI S-1•_?. - Cctt+ •U j-;: ' ,-,.--7i--:.-- ,i r
X��)r- - ,�•- l LENDING INSTITUTION LISTED HEREON,AND ' 4
L C 'sI4�., `J 0 ....
70 THE ASSIGNEES OF THE LENDING INSTI•
S c Y 6@ G �/ nP� TUTION. GUARANTEES ARE NOT TRANSFELA61f I�U�E f�IC(� VAN —1-1,1,,L. 4 . 4'
;'8' t/ ? 720•x. TO ADDITIONAL INSTITUTIONS OR SUBSEQUP* -i< �—
CgIII be Q���Fy Y OWNERS. A ` .
s,�*,gip - y V� 'C
s:JY ! Zu,c, _r," Licert�<.ec�# Lar .t S.Es-,,.:Li,eyN ',i
_•__•...._�..'...,..- �..-_._....,,,,,..,,,,....--__ -- '- >,,,.,a..^�••+es+.r+..�•r►.•-.a.... ._ w` 0.S S Y.r.C}'1 lc Qv i, 1-3 r'"N '-:/c,,, �4 .-J -