HomeMy WebLinkAboutMartz, Theodore Jr ,,,iii,--
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— i ELIZABETH A. NEVILLE �� h� y Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS V' i Southold, New York 11971
` �� Fax (631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER _ l #0111��, Telephone (631) 765 1800
FREEDOM OF INFORMATION OFFICER ,,,��� southoldtown.northfork.net
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4147-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner MARTZ JR, THEODORE C
Mailing Address 1 145 RYERSON AVENUE
Mailing Address 2
City St Zip MANORVILLE NY 11949-0000
Property Address 1 1250 ALBO DRIVE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 631-878-8443
Tax Map No. section 126.00 block 3 lot 8.000
Cross Street WELLS ROAD
Issue Date: 6/12/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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GIFFICE OF THE TOWN CLERK S\\TFO .I .
TOWN OFSOUTHOLD 0�� COG Application No.61J(/7
ELIZABETH A.NEVILLE,TOWN CLERK $10.00 - Residential XX
P.O.BOX 1179
SOUTHOLD,NEW YORK 11971 ,�� $25.00 - Non-Residential
Telephone o1 Y►���
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
RECEIVED APPLICATION
JUN — 5 2002 - for
OPERATION PERMIT
Southold Town Clerk
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE May 22, 2002
OWNER NAME: Theodore C. Martz Jr.
OWNER MAILING ADDRESS: 145 Ryerson avenue
Manorville, NY 11949
OWNER PROPERTY ADDRESS: 1250 Albo Drive
Matt-i urk, NY 11952
OWNER TELEPHONE NUMBER: (631)-878-8443
TAX MAP NO. : Section 126 Block 03 Lot 08
CROSS STREET: Wells Road
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New XX Existing
Residential XX 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.)
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Signature of A. :160,
RECEIVED
ToW p'erk's Office
DATE: qO
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J LOC. 2-25-02
6-O2 THE WATER SUPPLY, WELLS AND CESSPOOL
' LOCA TIONS SHOWN ARE FROM FIELD OBSERVATIONS
AND OR DATA OBTAINED FROM OTHERS.
OR 0.39 ACRES ELEVA TION DA TUM: ASSUMED
A TION OR ADD/TION TO THIS SURVEY IS A VIOLA TION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY
'E LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN
FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TIRE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION
TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE.
NSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE
JUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES, ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS EASEMENTS
STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY £l4D£NT ON THE PREMISES AT THE TIME OF SURVEY
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