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Home My WebLink AboutMacomber /4 ,-,17ilatt.„,A a <s y,,fi Town Hall, 53095 Main Road �® 0 �° �'' P.O. Box 1179 --t-,. 1:9,,-0,1,0;,--,v CI ��! Southold, New York 11971 JUDITH T.TERRY ---P--,...„,,,,,,,.',• FAX(516)765-1823 TOWN CLERK TELEPHONE(516)765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 1109-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New X Existing Name Of Owner MACOMBER, WALLACE D;,' Mailing Address 1 P. O. BOX 632 Mailing Address 2 City St Zip MATTITUCK NY 11952-0000 Property Address 1 1225 JACKSONS LANDING Property Address 2 City St Zip MATTITUCK NY 11952-0000 Owner Telephone No. 516-298-4562 Tax Map No. section 113.00 block 5 lot 8.000 Cross Street COX NECK ROAD Date Of Last Pump Out 0/00/00 Issue Date: 5/12/89 Judith T. Terry Southold Town Clerk (TOWN SEAL) OFFICE OF THE TOWN CLERK �FF0 Town of Southold �� `� CQ ' Application No. //� ' Judith T. Terry, Town Clerk fie, ,' ; Town Hall, 53095 Main Road .. Residential �. P. O. Box 1179 . ; mss; Non-Residential Southold, New York 11971 c::, Telephone o.( 1 • ' (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ /0 / DATE •J�f/J0/• OWNER NAME: � /L 4k /1//002.6/LW OWNER MAILING ADDRESS: !O /0207,5%k /( ati/ /JD//UF `� /f/ 7 JrZGi& 477 7/9 OWNER PROPERTY ADDRESS: /- O(/L- n OWNER TELEPHONE NUMBER: J��Gj// �� TAX MAP NO. : Section / ( 3 Block 06 Lot 0 F CROSS STREET: (., ©x Az-6 /`SAD TYPE OF SYSTEM: Septic Tank ✓ New " Existing Cesspool New tZ Existing Residential Non-Residential DATE OF PREVIOUS PUMP-OUT: /L"EJ 1` 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.) ,///d/A1 Signature of Applicant RECEIVED BY: C.'Town lerk's O ice DATE: )) SUFFOLK COUMTY HEALTH DEPARTMENT lib., + sawkE FAMILY MELLING ONLY • 11.11 PIEF.NO. DATE jjd ' KJL 11 190 T 16 `--"�-- 0E A3EVE POOAL.AND WATER SUPPLY FACILItIES FOR,TH18 "-r,; . 1 •TED BY THIS DEPARNIEhp AND �0 o/u )a .,y t /� I 3,.• ,if (7 • Sig- 91�! 1� O�•_ M T i �f _��• ooO Z w-O �� II t� 0 LOT I? 2.. Z vaca.�l po Q Vi _-, c a. v 61"4 _J LOT 23 Det 4 a : I�'o iI )�°PP aC .W y d bu Ch averh f W Z SI ro �' . o • N.. 0 • -/ 0) 0 p ' .' "ii til — NO �A !- V S- f)y I I V) w� nye .:SS Q • r• . 4 al - S.88° 34.40"W /"d 1' 192 UU' 7 ez G a..�L 1 LOT 22 5 • AREA ■ 22,425 SQ FT \ Dy O n -- - N Ivel;\,D w.,; .1.... - . .. �� Ia) U • • JACKSON ' S // , LANDING ` � CERTIFIED TO r e LONG ISLAND MORTGAGE CORP.. TERRA ABSTRACT • �,- WALLACE r4ACOM®ER .. SURVEY dote(' , 19 t O.�lt, • - LOT 23 f �b e� " MAPOF JACKSON'S LANA " 6 19 Q7 �'�s.� FILED MAR 28 , 1969 FILE NO. 5280 AT MATTITUCK - • TOWN OF SOUTHOL D SUFFOLK COUNTY , N . Y. 9LANDs 1000 acoE A.40`9i.„ - 113 - O 5 - O 8 u 4?ir �c��o • SCALE I " : 40' �' DEC 30, 1986 ' (i .r� ••' st i * FEB 2,197 7!�° 49 es pQ� N Y.S. LIC NO 4 966 8 Prepared In accordance est* the minimum standords for tide surveys as established by s the 1.I.A.L S. and approved and adopted Pte• ' S l I R V E Y O R S 4 ENGINEERS , p C 111 . for such use by The New York State Land (51 6 ) 76 5 - 5 020 Title Association. P.O BOY 909 THE LOCATION OF WELLS AND CESSPOOL SHOWN MAIN ROAD HEREON ARE FROM FIELD OBSERVATIONS AND DATA OBTAINED FROM SUUTHOLD, N Y 11971 86 - 796C