Loading...
HomeMy WebLinkAboutMarcus ElLirco F In a �\ -:0 Hall Town , 53095 Main Road P.O. Box 1179 � ��� Southold, New York 11971 JUDITH T.TERRY '- ���,,�r.'�`��� 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. 1219-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New Existing X Name Of Owner MARCUS, PETER Mailing Address 1 BOX 753 Mailing Address 2 City St Zip MATTITUCK NY 11952-0000 Property Address 1 300 GRAND AVENUE Property Address 2 City St Zip MATTITUCK NY 11952-0000 Owner Telephone No. 516-298-4993 Tax Map No. section 139.00 block 4 lot 7.000 Cross Street FREEMAN ROAD Date Of Last Pump Out 5/26/87 Issue Date: 8/25/89 Judith T. Terry Southold Town Clerk (TOWN SEAL) OFFICE OF THE TOWN CLERK eig ��WFOOr • Town of Southold � µ `G' , Application No.p-0 Judith T. Terry, Town Clerk { t r . C,7 $10.00.- Residential Town Hall, 53095 Main Road =< p. O. Box 1179cry3 r .., i $25.00 - Non-Residential Southold, New York 11971 c2,2411•..'' N" �� Telephone (516) 765-1801 TOWN OF SOUTHOLD • SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for - - - -- OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ • • DATE Alig 11 1929 OWNER NAME: Peter Larcus • OWNER MAILING ADDRESS: 333 Grand Av Rox 753 Vatti tuck 31e7 York 11952 OWNER PROPERTY ADDRESS: 30G Grand P.v T ttitrc' ,Tor iorl- OWNER TELEPHONE NUMBER: 297-0.93 TAX MAP NO. : Section 139 Block ! Lot 7 CROSS STREET: Freeman Road TYPE OF SYSTEM: Septic Tank New Existing Cesspool / New Existing Residential Non-Residential DATE OF PREVIOUS PUMP-OUT: ray 26 87 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\2- ignature of Applicant RECEIVED BY: Town Clerk's Office DATE: - \k, L, xSUFF.CO. HEALTH DEPT.APPROVAL i H.S. NO. N• - \ 77WNER: %,. - '\ __ .. _ :.r----:, -E.r.E.. ..' A4 J4-1 r: (1; (.1.5 :- - . . •,, ;.--, 3,0•X'. ;75'3 . .. , . . ..., • \ ; " IY(417-7-Tn..):.---kJ_ , N.NI. 1195Z , • , (-rer. Z98-4993) , lc) ,r.t-i--... AREA: 1.?..,•-:- :.5.,7.14. ' . . . . . . , • ... . DEED: Z?..,06e2e/„.) , 0 --1 . ..r,f.. •-r- . .1\, 11 ' I Vi 1 ' ' . I r- . , - . i i -0- , 0 - ' , , o- I 1 =2.11 -.._2' - 0 .. 1.1-1 . .,,;,•,--' s <> " ,,r \; i..:;:"-., ---...,---___,_„:.,.. . ., .......;..,„ c e.... i'Vic.)i_...0 1/ ..,. .,, .." :_ / ____. ...Li". .....,. .5) i • . . I-- - / . , . „ ,, 7•K . . , , ,... • .1.4)- •/ '..0 - (.4 () I •4. ' H----75-- - -- - - ------ ----0,', .- •: ; „ ''-' 7.- 0 IN N -. . ...427i-,—.2 .1-,, ' '' .,<,'• --.71----4°'—'). ' ---16-".-• t14:41-fid fli I. 1 . -•- ' 1-"Sig. ,t)2 '' ,----Pb• i . I 1.• 09 r, . , 0 e., iS ,,,,. 0 i,....:.--.1) 0.. • __,..,. SCALE: , 0 ., - , .. b , . tb7a. 0"-----1-110i;urtt eiii- • , . • ,---,, i 'f' 40 , -0_1_ 0 .,,, iecti pipe., . ..2? - 15 i' '. , - -17:- S'10'Z' 1. g Wet( • , . < , .. • ti / • ) • - . y'r cessipcx>1 N • i . ; , -- — r--2n-----• . • N ,i: .. . . :: ......_ UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF ...PI b . - .. ,.11-1 I, 1 __ _T ____, ___ __„________ ._ SECTION 7209 OF THE NEW YORK STATE I EDUCATION LAW. kft .._. , I COPIES OF THIS SURVEY MAP NOT BEARING .., RA 0 Z: , ,,. : 1 . ,C) . THE LAND SURVEYOR'S INKLD SEAL OR c, RI, , "N ii.:• ui • 1,CI i ,o. 0 EMBOSSED SEAL SHALL NOT DE CONSIDERED rt ,----7\ TO BE A VALID irmE.COPY, - - . ' . ) - GUARANTEES INDICATED EILP.E0M SHALL RUN ' ' N' -0' M • ; . , . , ,_. - ONLY TO*THE PERSON FOIR WHOM THE ELIM/g - / IS PREPARED,A1.D ON KS BEIIIALF 10 M --• g _ ' I • , TITLE COMPANY,GOVEZIW,EMAI.ADW.CY - I i ' ; ,. ' 1' - , • LENDING,1.1,15741117101,1 11STrED 4i-4W*/L TITLE ' 1 -• ' :' ,'`:'- CERTIF. 1.„4,104,ated Aa ' Z3,,5,78 TO 471fH.E.,21-511A-G"...........zre.A.;:,$).f Al?.4,1,,,,mmtiNam Alfilr . . , . ' TO'011Dmootita acirautacons OA PO-1E40W . . . s 'Guriecotteed +0 lire irrs- . ' -' 1 STAMP . - •M4POF'-''LOT5 Z,E-I;e,Z , ...., .. 5ecitit-,11-(i TiNe'arid Gbat'atiky Co. - , SEAL l' A4e4r `-CF,6Ateia,F.,A/ brErGH " ., al-rd 1-6 fife 5 a‘,..vi-At /rotvi`reep e3cofk - . ' " , . 51..)ffc;lk Co . tvip Na 577) , ' ,..1 5- 0,,, . /.jc-„by a9, 1977,- . ( . , RODERICK VAN TUYL. P. C. ' ' M417-7-1-17...1'c, ,c , - - .„ 0 ' V e4----•-• . 'el' 7-4-i•pz7e---- _ . ._ __ . . _r_.. • ____________ , • • Yo !ry oF .5ou---rHoLo,NEY _ LI - :-;•,-- — r• I C.LAND SURVEYORS-GREEN RT, N.Y. _ - . ' 5 oftoi k (" 7&kP:40:1?,0e:51:ytta-b To tr foe te,et-ti ':0;51. le:200,. ...--:-I:/. 9,-E3/c5 a k. 4,i. o+.7. ; - . . SUFF.CO.DEPT.-OF HEALTH SERVICES STATEMENT OF INTENT , , TEST HOLE. , ,' „ • . , , ' . . t______,_.,_C_i I : ' FOR A„PPROVAL'OF CONSTRUCTION,.,ONLY • . ,. .. ' . . , . , , ,, 'SCirld,,, , ' ' , '. ',,•. - , , THE .WATER SUPPLY AND SEWAGE, , '' toatt-fe-,;,•• . ' DATE: •; . . DISPOSAL SYSTEMS FOR THIS RESI- ' clav ,„.' , . . . , . . • . • i • - - ,' DENCE WILL 'CONFORM TO THE ' 5cirld H.S. REF. NO.: ' STANDARDS OF SUFFOLK,CO. DEPT. . ' ...I O HEALTH. SERVICES. • V / Vtictiee. , e , APPROVED: -, — • , . (9) , 1 - , • ARPLICANT' 17' . , . , _ , .