Loading...
HomeMy WebLinkAboutFarrell a Town Hall, 53095 Main Road $ P.O. Box 1179 its bm �� Southold,New York 11971 JUDITH T.TERRY �;r'�'�' 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. 1129-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New Existing X Name Of Owner FARRELL, EILEEN Mailing Address 1 BOX 253 Mailing Address 2 City St Zip LAUREL NY 11948-0000 Property Address 1 PECONIC BAY BOULEVARD Property Address 2 City St Zip LAUREL NY 11948-0000 Owner Telephone No. 516-298-4461 Tax Map No. section 145.00 block 2 lot 7.000 Cross Street LAUREL LANE Date Of Last Pump Out 0/00/00 Issue Date: 6/01/89 Judith T. Terry Southold Town Clerk (TOWN SEAL) • 9 9 OFFICE OF THE TOWN CLERK osFOL%(r Town of Southold "�� �oG_ Application No. //°2y Judith T. Terry, Town Clerk y0�.=; :` % Town Hall, 53095 Main Road 7 Residential P. O. Box 1179 . ;,;,.. ;: � Non-Residential Southold, New York 11971 O' ® {'`- � Telephone • 16j ��� '.• (-516) 765-1801 - - - TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ • • \ DATE 31 k ((J /5 • OWNER NAME: i i t r `I OWNER MAILING ADDRESS: f' iç3 saes- L- 8 OWNER PROPERTY ADDRESS: tclj-vh e OWNER TELEPHONE NUMBER: di d( ® ef 41 I TAX MAP NO. : Section i4(S Block °(9 Lot CO CROSS STREET: TYPE OF SYSTEM: Septic Tank New ' Existing Cesspool New Existing Residential Non-Residential DATE OF PREVIOUS PUMP-OUT: ' 7Ce 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.) 6/2_ Signa re of Applicant RECEIVED ,BY:- Town Clerk's Office DATE: I r•AUIHUKILEU ALTERATION OR ACIDITIOI '0 EHIS ,UPV^' IS A VIOI^TS a I' O. V'`�hh . iful•..,-/2(19 JE LHE NEW YORK SlATE - J • EDUCATION LAW ` -• / COPIES OF THIS SURVEY MAP NOT BEARING - ��V• (HE LAND SURVEYOR'S INKED SEAL OR ; OO EMBOSSED SEAL SHALL NOT BE CONSIDERED i 6.4:15 ! TO BE A VALID TRUE COPY. �yO J 2) GUARANTEES INDICATED HEREON SHALL RUN �� \ `�a, 2) ONLY TO THE PERSON FOR WHOM THE SURVE' C'") 1• v IS PRET-A.ED AND ON HTE BEHALF TO THE ', �\ (ITLk C7MPNY, GOVERNMENTAL AGENCY ANC ‘ \ cNDII•0 fr,STITUTION LISTLD HEREON, AND rI THk i,, :-I;;NLTS OF THE I ENDING INSTI• <1( G T\ (n ' i L ' , „,ARAI(TEES ARE NOT TRANSFERABLE V( Sc� \ •, . 4J .(,NAL INSTITUTIONS OR SUBSEQUENT .1�.\ \ 0 \ Q \ Qi \ zz3 D I, 01 E o Y� • 2 n \ ,o -, ' D 0 s, \ i-,•-. \lye` \ s F,.a N (.... ,0,--) \. o.• N chi 6�, \ A \:-.,. ` \\ r"�t X 1\ 4- I } 1 \ 14.6 \J 1 n , o N 2 \ N C' 0 CTI \ 0 \ \ - \ N \-A N \\t l r Q \` W \ N• \ m Q \\ 4,1 • \ c \ ,Z A D 1 w -,, w ` - f \ l \ N L, , �, \\ e.d o, Y3 9- 55 \ a 0, FF a\6 FF'1'S V eV. 0 tO ' m FF :\5•''3 y, 41 pO11 Gt1 . .41 / • , NOTE: II =MONUMENT SUBDIVISION MAP FILED IN THE OFFICE SP 14� ‘°'?\\ �- OF THE CLERK OF SUFFOLK COUNTY L3' ' s•° T \ \k ON SEPT. 17, 1928 ,AS MAP NO. 212. �k '\ \\ ,e`0� - SUFFOLK CO TAX MAP \ ' ' E+ DIST. moo SECT.J BL.002 LOT.oo7 \ \ 0v ' \� cOe \ ,-\O„ SURVEY FOR \\ a;se, -JOSEPH E. FARRELL �` n LOT NO. '3 U . ' ' +" 17� =/ d s 0 ..DUDLEY PARK" _ o /4.1. LAUREL cv. $ If /^ \ TOWN OF SOUTHOLD GuAR NT' E I• --; :,, %"" /,\a .\ /o SUFF. CO., N.Y. MEADOWBROOK k ION;, ''kt ► I'. / ` 0 . h' , HOME TITLE DI .I J:I N Ozt*;,\ai- Rlti%, ; \ 4O TITLE INSURA g, CO (is / SCALE I° = I a 1 �• o, , FEB. 9, 1966 • 9 .Q, ..n, -. a ,r Q0` ' \� //, �� ill . FEB. 21, 1984 'Eti � I ::� '• � j'/<6) MAR. 30, 19 85 LAND SURVEYOR,N. . ` /Pt�4 +i4S45 RIVERHEAD, N.Y. "` NO. 84-1212 - '.