HomeMy WebLinkAboutShip •
O
JUDITH T. TERRY : ZtTown Hall, 53095 Main Road
TOWN CLERK : p ryi P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS � ' ,' Fax (516) 765-1823
MARRIAGE OFFICER 41: • •• Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER SW
FREEDOM OF INFORMATION OFFICER ���i00
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 149-N Residential Non-Residential X
Fee $ 25.00 New Existing X
Name Of Owner SHIP, JOANNE C.
Mailing Address 1 BOX 1013
Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
Property Address 1 445 PIKE STREET
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-8962
Tax Map No. section 140.00 block 2 lot 19.000
Cross Street LOVE LANE
Issue Date: 10/18/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
l ••
OFFICE OF THE liOWN' CLERK
Town of Southolli , O� OG Application No./W,V,4
Judith T. Terry, Town Clerk t
Town Hall, 53095 Main Road _ %� $10.00 - Residential
P. O. Box 1179 tri `' $25.00 - Non-Residential
Southold, New York 11971 O 0"/
*.$
Telephone 0 ,
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
(15 Fee $
DATE /0//V4(-7/
OWNER NAME: J OoNN'2, lam' . ►
OWNER MAILING ADDRESS: U®)c` iO[?j
IMo.,C; 1-0 c.k-f 1\1`.V . ? (C c2..
OWNER PROPERTY ADDRESS: ' A re_ S*
M�. J � .y , 119 z
OWNER TELEPHONE NUMBER: 29 ?.-R-96 2_
TAX MAP NO. : Section No Block 2 Lot / 7
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.)
O ;„,
Signature of Appl' ant
RECEIVED BY:
Town Clerk's Office
DATE:
3
s / ,,(,!Q\ I ✓NAUTHORIL:D ALTERA'ON OR ADDITIOII
/ ` Si
I ' 1-0 THIS SURVEY IS A VIOLATION OF
C 11
(C j(f ` SECTION 7209 OF THE NEW YORK STATE
/ '' EDUCATION LAW
�t F
`` COiIES OF THIS SUPVEY .�-�? NOT FEARING
1 : , ' L' THE L','D SU:V.v:-3 - $AL GR
n X93 � .��
E!-"SOS ED S-:._ S H CE CON$ICET..ED
\ \O = LA - to SE A VALID r',,9 COPY
\ i• OtrLY T P., INS.S r ,• 'ECkJ SHALL RUN
\ i Cho C� 7 OtdY TO T`�' P_-.S_ w6,Ord THE SJRVf:
\----
• \. rG sq. \ O_ -� ' \ IS F^E7A::D, A.0- .:,I4LF TO !HE
I TITLE CQ .'-IY ,,/ - .,AL ACL:'•CY ,NC
11► Q QNLENDING ISTtT:.L, ncF AN, AND
L ' \ Piceai l 1 q 0. \ TO THE ASSG' .5 -, I.-1 ,E,P1r.G IH3'9-
0 TUTION Cv+-•. '.:S T ttOi Tr'AhF
`= e?LE
TO A6.rI?ONaL IN'^='1:It.NS OR SUt•'.IOt4`t41
N\ �•�� N C ...vaeS
\ . / k 1. :
1 co
>° NG• \NG \ I
1,eL,.L GeV\\,°
• i
AI,
o.z 0• 1;
I. \,
C.� d se I,
Ptt %- ,
PSpt' \ - .,
o a \\ O i� NOTEMONUMENT FOUND
, �j� 100
cs
o �j'/�_6 � ,,� ; >v� YOUNG & YOUNG -
\ N y I REVISIONS
W• 4.1 • 16 P L3° R !9 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK
1 8 HOWARD W. YOUNG
sP 6 ALDEN W. YOUNG
1" 5• - PROFESSIONAL ENGINEER AND LAND SURVEYOR
���` '! I - LAND SURVEYOR. N.Y S. LIC. NO. 12845 N.Y.S. LIC. NO. 45893
\' `�� 1 SURVEY FOR: LIC.,
PJOANNE G. SHIP °Fh�'``..;s'''' ,14.
W•
GUAt,�ANTEE... CO: AS SURVEI'E[T,4/26/80
rri
AT MATTITUC'K JOAN , SHI ,' ' 0lr'
SOOT .•L$ SQ OS,BANJC.:,:, :4- S
TOWN OF SOUTH0L6 OMME'�' �aT LANGTIT�EI� �q}NCECo
g
1 ` SUFFOLK CO., N.Y. B^/l ��� yA E,1t ,
C� n _4i
/ SCALE: i I = 301 1OATE AUG.20,I984 I '� 84-801 ,
- I
OIEfZCEN 135 11846 -