Loading...
HomeMy WebLinkAboutLarsen .; ^' ,,- r - , -_'_ 7---7----7,--,-77,--„F:,-: - r,.1Y'-,.P-1•7;.."-,77-\_ i __ L,r U,-r y%-'''r`F r,:,_, _;,oi,ti: - __—.. '': ^'^, - .': C .r+ _. - - _ - «{-� - - - '.`J'' r - �,;1,ei err ms='' `, ,{ , - rr - r _ Cri '�" 4 - _ � .- :ct. _ .:-i,..`,-1,e"I � 'f ryn^•�rit,�:::,�.'._ •r:•'Cr,.�' - 3 _ ••''''.- _ - n_- . ` f,7, 's - ',QFFCCE�:OFr THE'�_L-TOWN _E K;';', - ``F•,,,,;%:-_,r _ ,:,. `,..i,->. - - --�`".. ,, -- -vs'"`=' i ic., ,'A'r =�V, v,C ^+�h"; .>„` 'rf'' - '1• j Towrr=,of„-S_ou_thold;.yr� _ -- #��:; -,-,'r`' ,� - OG i ' .,--- ' , - ''; iudritl =.T ;;'=T,erry-„ .Town~;Gl.erk,_:,;. ” - ''•%% � ,-- • r. , -`r - - - ' 1= wTown'rr la11,, 53095jMa n:.Roadt +� �` " - k- '•- i ,?,t' r ,.C�.,..,.•t�,•svT'} �� M Z•-,,'"- ,'- - _ - ° 4` , ' • -,' - ,,),, ' ,'P'.�1O BoX==:1 79'_ _ ,_y- , (f7, _.,:l.,.. - ml. .. ''v` _Sp,F•a'' • . - z c �?_,{• ' �,�� L.-Lute Hca - >-,Southold New,,X•ork-,1.1=971+•;'` --;,,,7.-_-- p �.•, ,7,,, ' (, ' d ' '' 'ra.:-r', ^Z-- /^?I? _'' �n-`'"F,'..;"-Tr,..,-',7<. _ r,[.�,>f.1-,,,./7,,.'„::', J _ � - • ,.PP - __ - +1 `tl 1 ;.c -''h u' _ _:us' '> -r ..n•�° .0,• ;'Y 3, - = Oil_,- - __ - f'''t -i,.. �,, 1. - -�. "-' , •5,1`6 '=:7r659;8.01-,4 -", -t;, -!''-''• - : -i�,: - �� ' ir - h ' 'i 'r'' ,4f '� `f 1',t} t...4 .cfr ra' 9y_, - Fa,'f ',r. L. • y •Y' = , qq _ . ' TOW4I .rOF 'SpUTHOLD ,'.,' ` • ,,:r.•,,` , ,.,• ,} }, - - tic` 3''',"'r• Fr" ' -'-1 lt' '4r" `J`"h,,-,",.15^St: "t,- `;1rdr ,.y.'r - :{,,I- .c - `S' c 4'• , / - ,:r _.' , ,-':i?, i-,.-`"• z,- 'j- F''> r' �F'�' 'r 'SO;UTHOt.•?6: WAISTEWA-TER`-.DISPOSAL`?:DIST'RIGTu;; = '''',•'-,' ' • - f.�� _� ' +'J,'` - , '}' r;,ri ,���,'-{...:,, ut, i,.1'.`,".•",.,"•,-",r;-",-":1-- --"- :n-. `u'Si-- ,. - "`'r' - -'y,"- 1 _ _' , - , _ .- _' �,' _ �;,OP,.,ER'AT�IO�NL,;PERMI�T��:;'• -- -� , - _ '- .- ,_ -- . .' ;;�; ', .,y_ ,is_,$C,',1 �.i''-e..}✓F _ w='.:' Ja ,-6,rt'''± _ Amo,` r - .fir • ''' _ _ '�'-t. -'S '" tSEP:T-10-"TANK-10or---.CESSPOOL-1, ,,,, - _ ' - e - ,:, � i �S};"+y' �'`' =T. _. �- ,S-� - - gip, _ - •�(.-,`r ,r,'y„ ,(� ''''''.. 'S�-r'` • - - ` - , --, .,T"'' ly - - `•`S!k- r, mut'. - 'i•, .{ OPe --t��:�. ermit :77 FhL489 may' ,i. :rResidentia XX�2,1: _ ., i,i P; ` ::: - �_, - - - , N,on-Re17,1117, arl. :: ... ' ;e,- . - rr, •: - = f .. :::- -- '-`'_ w= `+ _ '".t;'- .-'.', ., `�,, , - f'=r :,Septi.`c;, ;_ '�Ce's spools 'x .i y" , -••y,, .•�•'"dyyy' • :♦ .,a -.2.. i -- . _ - F - Y; _ - . -• . ep. - '.,7. • • • 'J,`r ,- r -,.i'•-'err+."•4.. +m "1. - O • , ..r--.7---- . - _ - '• _ -r C, {x_ F':'i, N'AME :O F'>OWNERk:'; ".i • -,,E II Tyr_-,,41 `lr, T,, 1 ,.2...,..,.z.,-,-�'' , YF. .,1 -, . -:AME;.0-fva1 _ .x_� rEllen-•M,.,.Larsen•.,._.,_: `,•=,� _�. �;��}.�=.��•��' � /.•:1,,, '• ' OWNERA MAMI, iF,G,'-':ADDRESS5: P<Q_ ,3:Bo_x,:.�384`�` _;,2_:,_71"::,--.1-,-,-_---- :== a_:_ • -- •iJ'` ><•ri,, ���' y,�rrr�i7d�. r,!)' Y,t' C' K� �Y"Y"•- ..r'{Y, - �.,:t�.,�'"-•.=,_ 4' ..-u„°� ,-:S _ -.y,A" - r� `,`rf_ ,tr= , - - :''Southold;hNew:'York`1197%h - _ -_-.- __- _`L---- �-. _- ,j.',�,, '� 'errr"�. -- - - � - '=,S'ii-i%"' •i!°, �r •� '-• ';k..7x"- ,/_=-+�.ryti - ,d_ - 'u ,,1"r�� :„• ,;QWNEiki-rt OPErr RTY:1;:'A_DDRESS;: _x4'-1'505.1414orthsRaad"4- = a - __> .-_. - = . s':.-' 1 -h4 M1> a ;Southoldf: '�New'"Xor{c '1.197r1�"; :-..'7;_•.__-_-k: r-. -._.- ----_yr __,it rL - ,•7, •r --no'. ,,y. ,n,, - -4 ___ •_rc,c-.•,t/,..-.-_,..r,�ta-•;>-., -7r, ,-,� •-' �~•'r "-',' .. 1, rI e qtr,' ,ii S_ ,� ~.'� •' •, t� ' - iOWNEIV-TEL'-EPHONE'INUMBER. -.-.516.4.765-11157.T.,.:,-_,` _• _'- "a _ -•. - ., r. ,- "Y: .'' ,••••• ,-y; ''' ,-�, r - _ � :y ' 1N1f` .. r � • r � •'f r -•,7s..s-..‘,.....a. (Y.`!'• __ ,rr-..it- ""'Yc `-^-•�' � ' - - I = r'! it ,r - yp'tc+r .i .',]i", .e •- ter, ^J`-r. .7� • _ - "'• _ St}� " -,•_ ,° b,"'l�;{.-y+s"y pt". `'].1� i�l`{ 'i,1 r•=-' - - ,,, ,i-, .,•{rt-,.,` ^' -.y , '.TAXA:.�MAP_,_,NO :,' Se'ctiori ;s `v:s'-BBlocktss .3 - , .= Lottt -_. ”-•---Y__ ;:. 'a : x - . _ ., 59 `------ , - 3`c-' - %22.3 _ _ 'L r. Ur. jY ---.; it'- ` t _Y'."'. �-,r>�;t`..y'�`F,:•. -,�" ,i�-" 4'-'-c--"--: v ---__ _ , ti • ` 1.1--;;;;; ',,L:',—,-_,.:1'r `J Y.'1 l .4:,'�i e--- ��-''...'',i-- ,''n-i' ".'` 'F f t r�,. f _ , �`�",'"(CROSS.,ST.REEl',..,r~."''�•-- .. ' ., �_;_•. � _ .. •_-___, -_ _,-. `f{{ ' Y -t.: __ - - .�,,��:,-_ .��,� - ����„aKehny s��Road'�- _ ,�^;_ - -- ',x.,_�._ _ �, ,�4: I,'” .(4ti,} . L. -'L-" - _ - r<:-• - -'''''-'-"--'7'-‘•; ',.5..-j':1-17.--;-:...';', - r - - .y..;�.:'''',...1/,'---;-.:-:::•4.-',.--;z1..--;'-'.,--.. ,. ,', - `-.,•7'' - - -•;,^ - - -;'i- "J�=r.' -- ti t• r,•LLL. _ .t a -'f,..-.±-'---7--,,' ,;.-t7v �,c. ., j'-''�1r." -'`'" fi ,,*;4ti,•A` if, `",Si _ _ :^3� - i,- , - - rr ,.`- F ,-/''''"i-'1-- �',o� _ ,i•'�4%" _- h`'�'�r J..v -•ti� =iYY" 'rte.. / - • •r- �� - - ' �{ti�' '�,- ' • <<,''y P it,-,„,..;,,,,,i;Ol-sYSTEAVN,-`,Se .ti gank� -i' ,sNew=�` :.-......_;•_.,....,- arr '_`Existing- �G;•-�` ,`',, - 'Tr ,-,? •r,�},P�,,,_ w•..,�°.' _., _}:f::.-_ `'t'.,_ a-,., 5- -u- - -�� ;g•' - -- -.--:,z;-- S. I r '1 r' +j:7 "` '1- ',''''''•r,F.fk 'i, :(`!i" - _ „+ - �, r,. VCesl, ;� 'tX . ; '. New+ `Ezstrn9z� X :, ,'tr. YAI'r ,r'` ti}":'l'••,:r...,:;..�A,:. - lyl -- - ,_ .Y ,, f ':L'''1- -,t,rAy _ '`h.,14 - :: `:.,i' u1 `1 cl', ' -7t".:.:.;1-'':_:,•,.: ,,.,„, - - .i y� _ rf� _r•° r. - r- ,• 1� ':, _ .,•i,'Y'p'.�,JS.,,- ,1d.,,c' .i - - _ _ _ c,`•_ =�e. _ ,f,;•��- _ _7. ' • -sReSidenrtial;�,i4•,,X;_ �— _ : Residential-` - r _i*_. '' ,t - 'r' ,'J` r�" 'i' - ,: OFFICE OF THE TOWN CLERK _ SOFpG`r - Town of Southold �o : CQG�, Application No. v6p' Judith T. Terry, Town Clerk ='` - Residential Town Hall, 53095 Main Road `" P. -0. Box 1179 v3 t- ' '.` Non-Residential Southold, New York 11971 OSA— R .` ���` Telephone '�?i 'i '� - (516)_ 765-1801 TOWN OF SOUTHOLD SOUTHOLD`WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $,/ DATE OWNER NAME: 11/ ,�,�rS�,�'v ' /7/101 OWNER MAILING ADDRESS: ,a. )) ,98)V (SW/AM/ 14///9 77 pw OWNER PROPERTY ADDRESS: - eAk? 'j/ 9p3 L / 6 714T- �y //D' OWNER TELEPHONE NUMBER: TAX MAP NO. : Section J Block Lot 4�s CROSS STREET: J7/9 /S £ TYPE OF SYSTEM: Septic Tank New Existing Cesspool New Existing Residential Non-Residential DATE OF PREVIOUS PUMP-OUT: /CfUU// 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.) 1/41;1E2) Signa ure of Applicant RECEIVED BY: Ceeley ,{ _P C �-c� ft=rk s O ice DATE: NOV 20 V SNOW TWO Cierk -416 a c• A., sgr .AZ"`-• •