The URL can be used to link to this page

Home My WebLink AboutDefriest " IOWA ® , Town Hall, 53095 Main Road izrb ��. P.O. Box 1179 4,i \&N.,,, 444 ' Southold, New York 11971 JUDITH T.TERRY --®i ErLI ti!Vo' 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. 99-N Residential Non-Residential X Fee $ as`-4'° Septic Cesspool X New Existing X Name Of Owner DEFR I EST, DAVID I . Mailing Address 1 MAIN ROAD Mailing Address 2 City St Zip SOUTHOLD NY 11971-0000 Property Address 1 MAIN ROAD Property Address 2 City St Zip SOUTHOLD NY 11971-0000 Owner Telephone No. 516-765-3850 Tax Map No. section 70 block 2 lot 4 Cross Street TUCKERS LANE Date Of Last Pump Out 1/01/86 Issue Date: 11/30/89 Judith T. Terry Southold Town Clerk . Y (TOWN SEAL) _ . OFFICE OF THE TOWN CLERK �S�FFOu -- Town of Southold C'Q Application No./1/R97 Judith T. Terry, Town Clerk , x a y =%:'` Town Hall, 53095 Main Road 0;:, T.=%%'\ :' $10.00 - Residential �; / P. O. Box 1179 u2 OR- ��`�r'"��. �i �` $25.00•=" Non-Residential '�/ Southold, New York 11971 Telephone :�,( ��0�'�� (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or' CESSPOOL Operation Permit No.,A// 9 • Fee $ D DATE Nov. /3/ / ?8'? • OWNER NAME: Dei ..r, i es'l e0-a/ #ome • • OWNER MAILING :ADDRESS: /f4/it A9oac( J'0 q1-1104( N.}1. 1/97/ OWNER- PROPERTY ADDRESS: 3 a e et, cadove OWNER TELEPHONE NUMBER: ..?/' 7t. 385b 70 TAX MAP NO. : Section 4.:14:141 Block &7o Lot -- 3 CROSS STREET: Nearesrf" lvckekJ Lft . TYPE OF SYSTEM: Septic Tank New Existing Cesspool t/ New Existing Residential Non-Residential DATE OF PREVIOUS PUMP-OUT: �ic,HS7� /9t9 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.) iga.4 Signature of Applicant RECEIVED BY: 1/0/ , ow CT k's Office DATE: //'2V71- '-.....• ' , . , . ' • . " . ' . , . __MAti__ ,. .--.1.....P1._&11-2' -.Fe); T. I-E5 1 , . • .. . , ., • . „ . , . . . -1:[0 /ELL 5C400 LDTSTI2iCTISIO, ' — 1 -- , . . . , n' 1- . . . . 1 ___...._.___;....,!".:t.:.._ ,..y_ :i',_L.,:- j,.7__ ..1,.14 EL : '''%,.. -st - ..i i , . . , . • , . . , . . . , , . . — ' 5759.['4' 0...'Et 33,.._0,04„ -1 . ._ -r:,•,-,-;-.----,---1 • --- , (142.0 . .„..,,, . .., • . , t •••••••••• .. --,- -- ,--____ , i -,„ - Lltf kJU.1_` 4./...r.,;, . _ . .• _ , • . •-3-- :ri's' -- ! ----I - ' . -, • )-, - • ,fC-P tf. .17.. ,OVZ.N.S.-OF 50LJTf-rrl r 12. Ni n'sy' " " • , . „ _ „ - . xl,'',.1-4 .- ._. ' • ..:,i ,ge.5-1-012y- 2-- % 1 7Ci ip 2j4e.").::...,1,. . , , v . . , • ., ... 5 kin • 1 - --. ._ 7:50-4AL-r:Pim:2_1411-'4G_ t-sraet-N _7-GAS:pum p _ 1 ,,,,,_, ,. i 1. . . . ;---- , ,c,...) , •• -.! ...._sc :.__,. - . - . , ... . , . , , du - 14.-170 ' ' i - 'L) , . , . , 1 . ah-,, • 1• iol' ., -I ' - - , . ',:-.1-_.caiqc.gs.,r4i.113s--- .1 1.• `,„,-.•;:;-'- -,-,-: •. • . • . ' • i -' "• )--.. .-.-;-;;•----'—. ---- ,_,-,-`•, i- ' . • -/,'"c0-0c42--;CC/R.--.9'. • : -, - -• - ,..„../ tfit , , ..P_• -..1-:714.A:,4-7-,;,,.D.V.A.Stfai,_.:,_,...,-,-;..,.:,- ___ . 1 , , - ' . . , (4_____-__--.: . ! . 8±--- --.1-,-.415416'_30'w, - iz.-5-i'),..• --(q55;04 , .. „ • , T.G1';;,2,.., • ' ---.____J - '"*".-- , , .T.:_-_STAF.a, . . •- 1 -s. sx, , . . • , • , • - • m..='i 1 71-STO ay- . , , r ----___:r. ii - la u-1 • fr,_. k, -3 , tai 1---..,..., ----, 'CIA 'CO . Li •4;4 , ' • ' I ' ..s:F12.-.1-4 0. ,, , _ , . -.4P-0-- • 'c'ii” 6 ul M ' -i....1 , t,...)t '-z-,-, ,(.) _cKftt.:trte..-. .Ill Y.* / ' . -?-.",------.."';'f` l'`'' 7f,''5'/,' bl, . -..,. t,_ tft:,t , - MN I r 1 0 .. . 1 • 1 ' r', • ''''"'1-1-1 •• 0 • —_. -- i ,..., / 17-1-1' \-. --------,-1--TZT.. ----L---------- -----(') CP:if , LO -"--1 --e -,4 — —13 -- "---------ca....i f H.:, ; L 1 f ifii 1 1 ' t .1 ::;0) L-.-PI,_ .th _ . \ t....,-*_. . ... ---TAL E ?.--0- I ...... . - . . , • 1 v '' _.. Pi,-. MOU ivi'Nfl" — , ic...,.. . • - "-, 1--1-r- 5.-7 .....,,t..,, N../ - - - --';ZI),'•::';!..',, ...,.. - , CY . .1"\?,..;_s:?,4.; ,..c....f. ic-_•:1, C› ir:IFP ''' , •.....---,..-ii',7"V'IrM,-C,:4 VOn \ i‘‘\.....TOTALAR E k--c",260E, F-= . '5 „ 'NA r.,c,i.:2?.i0,-,tr, ,,,,,,; _....,-;;,-:. J 1 El ' - - TEP , , ,----.-_,--"•--e.,the IYJvi York Stcstc -:.7..,..,•p:n Law. ' ' • . ' 'I- of o, N....,r-tv mop not becrinit 1,-1,-t..i.,f.„.urvayor's inaed sea4 o. ,---oF N )-; _ :-.-1,,O.,qed S.93i shalt not be consideme \ 1 114,, , . 1;.,be a valid true copy, ‘ l), , - . C.tuarantees indicated hereon shall rcirt \ '4, /0 '1,5,,,Zi.., ,15t C:.-4 .v, , 0 , ' ,....•rly to the person for whom tho surmy 7-1, . , • 5E;preoarad.and on his el-iti5f to the ,\l'\';',Q,,,,, -.e s,A: /C) -1 • . i , ,t ' ' . . titc,,ccroozny,governmental n2,er.cy ond , CI '/;'-,..--,':.'',,",c"iv'''----co,,,c-1. I I I-•-' , ,..%-ndiriy institution listed horcon amd '1>ii, c)* t. ' bi'Y-kty 1 , to me.cseignees of the lending 1,nsti- \ ,s.„. ..._S2...5,,,,..-;.?. 3 , order, Guerantsas aro not trans/arable °,,•:•``,0 i , 3,:.-....b.;3,:a1 institutions or subsequent 1 , 0 ., .. ." teaU_, . , ' ' . - - - -- - --- - - - -- -- APRIL Pc' 1i1 . , . . , . , - • fr 1 '‘.. A i -7-i ' Pr ..___...fC)1;)EP ,.. ,te \,,I r' 21\\,. i (Jyt , . SUFE co -r-Ay' '1'4A.P-TA-14/I.• 1000--n 710- '1- c-''' 4 1.-. •-• - ' ' , , _ .,.. . . , - . _ _. ,......, .... . ... k i i .0. I%.•-• 1 1 .., •.,„ .... . . . . .• • . , ........„......---------..-.....- . ' . . . ' • • • i' . , • . /0 V ' . • • . • • , - . - - . 1- , - - .......--.......— — -, -•. - ... , • .. „ . - , . . ' . . _ . —,-...—.---. -.,- .•-.- . ........--. .1..,.1!..1, 1,,I.;\-KI 0 iStilTv'ErY0,r,..5- . : - - --.( 12e,F.:1.<,4POITI ‘,..1\i . - , - . . , .. — , c ' - b , . . . .. , . . . . - , . , . . . . . . . - . ,. . . . • . . . .