HomeMy WebLinkAboutMartz �•,
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ELIZABETH A.NEVILLE 4.�� 4% Town Hall, 53095 Main Road
TOWN CLERK , ® P.O. Box 1179
2 Southold,New York 11971
REGISTRAR OF VITAL STATISTICS Fax(516) 765-1823
MARRIAGE OFFICER : s�i01
RECORDS MANAGEMENT OFFICER . .0'
Telephone (516) 765 1800
FREEDOM OF INFORMATION OFFICER
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3798-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner MARTZ, THEODORE C. JR.
Mailing Address 1 145 RYERSON AVENUE
Mailing Address 2
City St Zip MANORVILLE NY 11911.9-0000
Property Address 1 1500 STANLEY ROAD
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-878-8443
Tax Map No. section 106.00 block 7 lot 38.000
Cross Street SUNNY LANE
Issue Date: 7/13/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK cl\FFQ
Town of Southold �QG Application No.379 8—
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road .c ,t„ $10.00 - Residential
p. O. Box 1179 ' + ;' $25.00 - Non-Residential
Southold, New York 11971 O »* �•`
Telephone OI
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DAT C)G Cl8
Laee .
OWNER NAME:
OWNER MAILING ADDRESS: /' --C-4Ct2r�
7 5411,01e0 c /(ci 697
OWNER PROPERTY ADDRESS: ISOon
OWNER TELEPHONE NUMBER: e'26 ^
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TAX MAP NO. : Section Block 0-2 08g
08g
CROSS STREET:
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool 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.)
,iier:40,
Signature of Applic: •
RECEIVED BY: AL ALet..4,—z
Town Clerk' Office
DATE: (72/C1/ 9
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REF 0140! 1000 -106-07-038 . 1.:0 Qs 000B SEC.SND. JOB 8776
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SURVEY OF PROPERTY
Situated at Surveyed by
• .MA T T I T UCI' SMITH ( JUNG
TOWN OF 5OUTNOLOS Ykoz`e%SUFFOLK COUNTY Professional Land Surveyor
NEW YORK 120 MEDFOR0 AVE..
SCALE: lr=2.0' PATCHOGUE; N.Y.
Phone 475-3192 '
Survey Certified to : LUT NO �NC�WN HEREON REFER TO MAP OF SUNSETF/l7E !TY NHT/ONAC T/TSF co.
1 NTERCOUNTY MORTGAGE COMPANY KAIOCL-s -SEC. 2; F/LED ROR/1 9,1970 4S CC FILE N°5448.
CHRISTOPHER WEBB D4rw4: 4330MED
FOUNDATION F1NgL SURVEY
LOCATION SURVEY T/
DATES SURVEYED :DECEMBER 18, 1997 ; APRIL 4,1998 ; JUNE 1, 1998 /
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