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HomeMy WebLinkAboutK&D Assoc OFFICE OF THE •TOWN CLERK Town of Southold A� , . Judith T. Terry, Town Clerk Z = w: �' Town Hall, 53095 Main Road P. O. Box 1179 '. - Southold, New York 11971 Q �ON._ • Telephone - 0.( [ (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. NR 61 Residential Fee $ 25.00 Non-Residential X - - Septic Cesspool X NAME OF OWNER: K & D Associates OWNER MAILING ADDRESS: 31855 Main Road Cutchogue, New York 11935 OWNER PROPERTY ADDRESS: 31855 Main Road Cutchogue, New York OWNER TELEPHONE NUMBER: 516-734-5657 TAX MAP NO. : Section 97 Block 5 Lot 10 CROSS STREET: Harbor Lane TYPE OF SYSTEM: Septic Tank New Existing _, Cesspool X New g X Residential X Non-Residential DATE OF PREVIOUS PUMP-OUT: Unknown Judith T. Te Y Southold Town Clerk DATE: February 16, 1988 - - _ _ (TOWN SEAL) OFFICE• OF THE TOWN CLERK • I ,j�FFr4L'''= - Town of Southold �V % CQG' Application No. Judith T. Terry, Town Clerk Town Hall, 53095 Main Road ; Residential ` . P. O. Box 1179 -�� IOW , Non-Residential � x 7 Southold, New York 11971 O ® Telephone (516) 765-1801 . 1 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. ✓u (`p Fee $ DATE "'0(4) �/ l ( 4) OWNER NAME: c�'' D � S' OG 1 ' 3 OWNER MAILING ADDRESS: 3i fS'S' ,'2- / 7' //71J1 OWNER PROPERTY ADDRESS: OWNER TELEPHONE NUMBER&4) 7 d 5/-" ...4?-r7 TAX MAP NO. : Section /0 0 ('' Block 9 7 Lot malt'' 01 CROSS STREET: - LscL�J� TYPE OF SYSTEM: Septic Tank Il New Existing V Cesspool ✓ New Existing V' Residential Non-Residential DATE OF PREVIOUS PUMP-OUT: ONxrypws✓.., 02eg,vy6L,E /est 7i/ix 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.) 7 �/ 1 /‘ / Signature of Applis '" RECEIVED BY: n ,(je, • To CI rk's Office - DATE: /& fr 7.. 3 0<y—'—:°. 2... SUF - i..;� co..t-RAS._ `:s.f A P c + , . . . _ i tztA3-O.. . r l.37058120yE. . £ 0.•! _ _ ' 43 i WELL f iJ MAP_ _ .�.f l O . PROPERTY _ _ • ', t.0- Ay 1 - "v UfVEY2 . . , ,,,.. . ._-______:„:,,-„,- ,,..--...., _,.., :Jr b I 0 NI EID FDO 7 if . ,_ , .., ° JAL — 0-4, 1411 EL t.\\3 /2.. BOUt...i\',4."--"" P & ''. - ' . . . - EA ..,0 , ., . , ' fi) i . .._. . .._.. . . . ...„,,, . .e.. i- 0 7 .. / \ • tit- 97 is 2 •:::, ..,,-- .... . • J Cr ... _ Z. u, J ,'� ....... e �'s ? AIFIHORIZED ALTEROE1 UR ADDITIOR 1./. `- C1= CIO THIS SURVEY IS A VIOLATION OF 8 ® - -W JFC�JON 7209 OF THE NEW YORK STATE 'r ( 4CL' %s _ FA ATION LAW. �JT�1 •i�9 4 6S ry ,' ® • RQP1Ei OF THIS SURVEY MAP I�O ARIF.G • A +t � �- L tid co s �_ PIE LAND SURVEYOR'S IM(s)'SFEM.OR 1 - N a 40 ' ROOMED SEAL SHALL�tOT t(CONSIDEREa -0 ..:0_I :C:!i- (f') ` e' ,,,, , -, LO EEA VALID TRUY/CCOOPY' - t N� yam. ��( ~� Q P�ARAN[EE5 ICI1TED HEREON SHALL RUN .� di pltLY T9 E PERSON FOR WHOM THE SERV. qCO S T' 0.'��'',,j _ ) ,, IS PREP RED AND ON HIS BEHALF TO C F 6.Jjob_ .� `.?" IiCO ANY,GOVERNMENTAL AGENCY E int —+ LEND INSTITUTION LISTED HEWN, AM z �-�a5 I HE ASSIONEES'OF THE LENDING INfiT' 0 IOEh GUARANTEES ARE NOT TRAMBFE. v 4 .wry' / �p� r/ /'- f ADDITIONAL EFA��n ttTwc rn cults. .3a6-S,Ib.d_�Cad Y Sf iO•�r�1""f G.�J r (t/ S�' A/ �h 6..., 7WNERSa E i i ." _ GUA2ANTED TO T€-IE SOUTHO DSA iNG5 BANIt , i �,I_�`J ! 0,�$ GUAT-Ai,11EE) TO THE C4!CAGO T;TLE §N5U kicE CO. # - - • P5 5U12VEYED i2R: � 3 f 3.� 0-NUfrfE`'41 - - - /2 10/ SUFF. CO, 1 .`.C. MAP_'.a03 -97.5-10. 1.10.LANE.; SUt �JEYt;fes:. I�E i IP°W l N �' o • 1F i