HomeMy WebLinkAboutKreiling .
JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK "• - �'e P.O. Box 1 179
REGISTRAR OF VITAL STATISTICS ' ! ' \+ ' Southold, New York 11971
MARRIAGE OFFICER .r " ' `� Fax (516) 765-1823
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. 1617-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing • X
Name Of Owner KREILING, GEORGE AND FRANCES
Mailing Address 1 BOX 757
Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
Property Address 1 855 LUPTON POINT
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-4927
Tax Map No. section 115.00 block 11 lot 5.000
Cross Street MARATOOKA ROAD
Date Of Last Pump Out 0/00/00
Agovt
Issue Date: 1/17/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
r ,I�
OFFICE, OF T,HE TOWN CLERK c�VFFD(,�
Tbwr '6f Southold CQG� Application No.
Judith T. Terry, Town Clerk ��'� $10.00 - Residential
Town Hall, 53095 Main Road -S .
p. 0. Box 1179 cn rZ< r x, ;µ, Pi ; $25.00 - Non-Residential
Southold, New York 11971 O'er®t'T'' = .$
Telephone 1O11t. #".•
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
fors.
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE '
'OWNER NAME: LD e ~ ��Z C ira'
•
OWNER MAILING ADDRESS: 250 ( 757
/( 4 A
OWNER PROPERTY ADDRESS: ) 5 L � N !y tu,t
CYAltitlaci Ny
OWNER TELEPHONE NUMBER: �-- L7L• 127
TAX MAP NO. : Section 1/5'
Block 1/ Lot
CROSS STREET: fI'/1a', t?'1ak4
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential 7Non-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.)
INF at moi•-' of pplican
RECEIVED BY: /1"
/''• n Clerk's Office
DATE:
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. •�+ . MAP OF PQOPER1-y ,
k-•-•, SURVEYED P - ,
,. +GEORGE W. c" - FFAANC'E5 V. KRE'fLING
* `i, - '•1,, ^_ ___.�_-�T;r3:7th4�13''-3 clt-xatiAn or md��tion '
'�` ,',..f., • + •,, _ • ,y' 7- - _ - t4 this survey i4 a violation of
t?acre'6 lr J t.ad..rQ -S 0atI ec .45 d is[1�5a .- •'
' ' ` •• .• ', '.•+ S3rt,cm 720%of the New York Stat°
- . '''' • LUP7'OfS1 S P01Al /' Education Law. ,Bane C9$ sarveyed, rula y• Z7,1,9,87- v- - ' Copie?of th survey mep n^-t!yawing r) t { �I t .�J f - M �+
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x;Y i4 ! �• d•: - ' _ 'emboss-se seal siv'I net be considered r
• - - __ __ r to be a vain truo cc;Y• e G-...--. ! �. OF NE{y
'< • Csuarantera indicrtea herron shrll ni^ /�Q�P�CK V�ti rp
~ z. _ only to tha,person for whom the survey CO O N,,�
,Y,. �: �C is prenarsd,ane on hip behalf to itie L/Ceti Sed • Ld nd . Glomi/$ itl Yr:1 4 C•
`V• '+; L] rJZ/R9�'f! :•- '""r title company.governments!agency end < 4,
et ti ''_ = n „t,•,w' .' Iandtng institution listed hereon arr,3
< ,_` k?: �f"0 ;:f'1 C„t'v1t 1r -' to the aen�9neos d the londina ir✓ati 6Ye a ilibei r ',..N. Y.. "y�M: O '
;'. -Ac--”. ,y' ---->4'Q. rtAy 7-421(.:. igri:.'e!'r .-t : r. "-Y' =+,.-;• tution.Guarantees aro not tranatareble CSL •
J• j -1'...,r., v7 "(t ' . ,:~,2 '''.;L:xr=•.•te additional institutions er subsequent �•;4- '' s+ 4 s 256
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