HomeMy WebLinkAboutBreuer, Yvonne of OFF01/("
,ELIZABETH A. NEVILLE ��= %: Town Hall, 53095 Main Road
TOWN CLERK o - P.O. Box 1179
REGISTRAR,OF VITAL STATISTICS Fax (631) 765-6145
yy, Southold, New York 11971
MARRIAGE OFFICER � ,
RECORDS MANAGEMENT OFFICER --74q1 *DI Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net
OFFICE OF THE TOWN.n CLERK
SOUTHOLD VTAImff tutu J AL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4170-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner BREUER, YVONNE & AUGUSTINE, R
Mailing Address 1 116-15 N. CONDUIT AVENUE
Mailing Address 2
City St Zip S. OZONE PARK NY 11420-0000
Property Address 1 50 THREE WATERS LANE
Property Address 2
City St Zip ORIENT NY 11957-0000
Owner Telephone No. 718-848-3255
Tax Map No. section 15.00 block 6 lot 30.000
Cross Street PLUM ISLAND LANE
Issue Date: 10/17/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
u...
OFFICE OF THE TOWN CLERK c31 ,�
TOWN OFSOUTHOLD ,&.0COIj Application No.l� 7�
ELIZABETH A.NEVILLE,TOWN CLERK $10.00 - Residential
P.O.BOX I l79
SOUTHOLD,NEW YORK 11971 $25.00 - Non-Residential
Telephone 70 44 1 '•
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 0607 l�
Fee $ /0, tri)
DATE ` ' ��- Dy
QQ ,
OWNER NAME: 1,//I/ IC E�/I�� f &72� /4051157//✓�
OWNER MAILING ADDRESS: //6-/5' /Yeeil/D4'i t /E
6 2 WE PR , _ 0-0
OWNER PROPERTY ADDRESS: CO ///j2�- - 11/9--2--43
eViejE rh P /A'7 , N y /1951
OWNER TELEPHONE NUMBER: 2/F- ffgf -
TAX MAP NO. : Section /5—, 00 Block (D Lot 30. ood
CROSS STREET: P/u ,y 7g /,51,v7i
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool ?C 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.)
/
�.4. I ,
Signa ure of App icant
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RECEIVED BY: Of I /. .
-TOW ♦lerrk's Of i -
DATE:
- R10 - 0L - 00'2-40
SURVEY OF
. LOT 5
itdp of
ORIENT BY THE SEA
tcrioN O
�fqb�
FLE No. 2777 FILED (NOVEMBER 21, 1957
46\4`,:iSITUATED AT
2s $� '" ' ORIENT POINT
1 </'� TOWN OF SOUTHOLD
0,5°N, 10.D
�I
.w..� p�o� SUFFOLK COUNTY, NEW YORK
-
S.C. TAX No. 1000-15-06-30
Fr C x,.� t'-1 0 F\\ SCALE 1"=30'
O JANUARY 24, 2002
6)",�� O FEBRUARY 26, 2002 ADDED ADDITIONAL RILL at SEPTIC LOCATIONS
2.9' \ & REVISED PROP_ MI£1L & SEPTIC LOCATIONS
�.+ p MINE 13, 2002 FOUNDATION LOCATION
5 8 AUGUST 200,:52 FINAL SURVEY
a AREA = 19.98 sq. tt.
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