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o,lei,,,, „. 1�' � Town Hall, 53095 Main Road %` ' * ' P.O. Box 1179 =�Ql * `Ak 0' Southold, New York 11971 JUDITH T. TERRY -•0,, ,o-- / TELEPHONE TOWN CLERK (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. 84-N Residential Non-Residential X Fee $ 25.00 Septic Cesspool X New X Existing Name Of Owner JUNGE, ARTHUR V. Mailing Address 1 P. O. BOX 768 Mailing Address 2 City St Zip CUTCHOGUE NY 11935-0000 Property Address 1 22355 COUNTY ROUTE 48 Property Address 2 City St Zip CUTCHOGUE NY 11935-0000 Owner Telephone No. 516-734-5203 Tax Map No. section 96.00 block 1 lot 19.000 Cross Street COX LANE Date Of Last Pump Out 0/00/00 Issue Date: 3/31/89 Judith T. Terry Southold Town Clerk (TOWN SEAL) OFFICE OF THE TOWN CLERK &v, �°+i FUCK' D Town of Southold Judith T. Terry, Town Clerk "+ Application No. 174/ *;u Town Hall, 53095 Main Road F ; Construction P. 0. Box 1179 Alteration Southold, New York 11971 Nei Telephone 01 Residential (516) 765-1801 Non-Residential TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for © P6r�Frio.� C or PERMIT SEPTIC TANK or CESSPOOL Permit No./Vie Fee $ /6 DATE 3/-e_52472 APPLICANT NAME: I (.1 (.2 n G APPLICANT ADDRESS: 5452Z-,?2/ / v Gi U Le 7/; SEPTIC 7CESSPOOL DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION / - / / LOCATION MAP: Must be attached hereto before permit may be issued. LOCATION OF PROPOSED CONSTR CT)ON ORA TERATION: OWNER OF PROPERTY: (lr - \/1.2 e OWNER MAILING ADDRESS: 7669 OWNER PROPERTY ADDRESS: 2_2._ 3 S Grp-- J 9e TELEPHONE NUMBER OF CONTACT PERSON: U 3 TAX MAP NO. : Section 96 Block l Lot CROSS STREET`. BUILDING PERMIT NUMBER CROSS REFERENCE: /A/l/L/1 Signature of A.plica RECEIVED BY: 4.,tac-, •ll w e g g qr© D/Cle k' 'Office DATE: • • TI i : r• r t.4.2E 14 CX-:' f_. r * _- - ..- _ d ---- ' -_ R - WELL --� . NIAI--) Ok [- F< L F .. c, r T • • ' 449 e."'' (\.1t) LI) � U1'\/ _VEL.% 1:0 R , y1P,R 13 c•. Wu /,, r,) y (---- - I , (__.1 - AiTHt.J f �� *-Li , 1...; _�f �,! ' -� 4..� t, •; '�... . .C. ' Al- i j t 1I I > Ct..�-1•-i-i t.:t.I t._ (--- — – — — — L`i T��r�`/ r(__�____ r __ I_r; 1_ti1,`,? �_; ' ( , .� t SUFFOLK COUNTY .,,. t .t , , METAL F: ; ,"- , DEPARTMENT OF HEALTH SERVICES .,, Approval of Constructed Works /' 1 i ra _ .�__ -_ !.'...-_.P.,• - - �7 2 t �(} H.D. Ref. No. /l�-�'7 _ s/ y� ;+��~ �,- r The sewage disposal and water supply �a g N pp y facilites at this location r ✓ �f 7T�t�!!t\ 1"3 have been sat.stacto•ply ms;ci!eJ by this Department and are; L CE55i�CrS?E i ,+ r ;s� in compliance-with'these as bu;lt plans. - �� "°„�; `,' q+ }/,P�, — t f 1AR 3 0 1989 ,St. faw- (IL �-3t1,. -FE a DATE _ ��GENERAL , •+ t 'n:e3s in i'i.ab•a h9.rq„ 1i3,� a C � OF — — ren;or who,: ' - — --- - - EJVGINF\ERING SERVICES c-- _t1,i._ ��. r n,`- t (1!'GB 1�-i. _ ..s'�' % _ 3 a ---•.s �.-.._J^"--.14- .i 47�� .. .I^. .�,t r��'�t'i.,., 'V "t- r,” I �Jt•1h1tic-) .rr; t._�,tiF. / �= P1F`C n, ,.,tor+�nr' k MAP AMEF•IUFO- FEB.I4,1989 t`1ill'C.)1 L C.12. 46 1.'C'ftil ' -------- — – 1 I �,��• .....,.,oz.i h ^zo , �.I I ,l 1, r: r•• i ; . J,' ,'- (^,'t A,i( "1"( -T ' ) i,( 1u5. 1