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HomeMy WebLinkAboutFinn . JUDITH T. TERRY ATG=== Town Hall, 53095 Main Road _ P.O. Box 1179 TOWN CLERK tz. ® L F REGISTRAR OF VITAL STATISTICS $ Southold, New York 11971 MARRIAGE OFFICER �=". '4 Fax (516) 765-1823 NA/ ®e! Telephone (516) 765-1801 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 2005-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New Existing X Name Of Owner FINN, JUDY Mailing Address 1 BOX 337 Mailing Address 2 City St Zip LAUREL NY 11948-0000 Property Address 1 PECONIC BAY BLVD. Property Address 2 City St Zip LAUREL NY 11948-0000 Owner Telephone No. 516-298-4452 Tax Map No. section 126.00 block 5 lot 19.000 Cross Street BRAY AVENUE 8 SIGSBEE ROAD Date Of Last Pump Out 0/00/86 Issue Date: 11/13/92 Judith T. Terry Southold Town Clerk (TOWN SEAL) OFFICE OF THE TOWN CLERK c3VFFO(,(���- _ Town of Southold CQ ' , Application No.�©Q 5 ', Judith T. Terry, Town Clerk 4t �►�' Town Hall, 53095 Main Road `''" '; r< $10.00 - Residential p. O. Box 1179 tri th V; ,,= $25.00 - Non-Residential Southold, New York 11971 O' ,tY` • �`� Telephone j * (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICAT ION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ /U DATE • /2 /7Z_ OWNER NAME: OWNER MAILING ADDRESS: ,lex 3c3 7 - " /vf' J/%r OWNER PROPERTY ADDRESS: 1-yG/� e/c7` OWNER TELEPHONE NUMBER: oZ9�_yys Z TAX MAP NO. : Section /02Block /Oj Lot /Z - - CROSS STREET: Ay ' v e ohk ),JuLitzida.) TYPE OF SYSTEM: - Septic Tank _ V New Existing Cesspool x New Existing Residential Non-Residential DATE OF PREVIOUS PUMP-OUT: 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.) 1 gnat re of Applicant RECEIVED BY:: ; Town Clerk's Office RECEIVED - DATE: - NOV1 ? 1992 ` ion Clerk &MHO n:: • • UNAUTHORIZED ALTERA710 •~ K • TO THIS SURVEY IS NOR ADD r A VIOLATION OF �,� C` 'N ••,..-- B ,7 / EDUCATION LAW.SECTION 7209 THE NEW YORK STATE F. CdFI[S OF iH15 SURVEY MAp NO7 BEARING /' • „iFFI: LA.D SURVEOR'S INKED SEAL OR �_ - ,---- •("4 --• _ _ r' EMBOSSED SEAL SHA /�' LL NOT BE CONSIDERED TO BE A VALID TRUE COPY.- . LO �.1 r, 1 :/ • V GUARANTEES INDICATED,y�REON SHALL RUN ONLY TO THE;;L 5 vUR WHOM THE SUR 4 IS PREPARED, ` .D U,,NIS BEHALF TO THE iITLE COMPANY, GOV_RNMENTAL AG:.Ci Al LENDING INST;T(I,,N LISTED HEREU.,, A D TO THF A:S C,;;EES OF THE LENDING INSTM 3 7 TUTIO,•IaUARANTEFS ARE NOi iRANSFERAME TIONAL INSTITUTIONS OR SUB$EQUgt m• / 6” a i / . 1/44J } fi . . ' 1 it` , / Lo- ,-- i i - i Wc�c�< 3 • ;.1 s+'i I i i Maw OF L, ANt �t,/ .�\ I Wm ill 025.6 r E • . LI G.: F U 2 • N I • 7z=.�5o .5. 1+4- 6' j •t •j I i vnt �q-r • y .a 36 I4 >. • 1 .... „ s ; a 4,2'— t ' r - T ;v,,c.r O l=. ==%:) �H aLF�; r.t.Y. • mabr; k .140 `-� - a 1 -t, • L::t S ;'�Z in " r1iaHt<rftei-t± s ® : IYOht p - as.._ /".. S{ Ps_ • o a in 1,11 . - +o" Male, 4.,4'>.R. L. 0,1•.nKti" -Filed in ' o in . °_ C) . 1�- ;-eke St�i-F+4,tk. Courtly Clerics afficc • �� d os Mio�, Nm 1 . , " • A a‘ 1 - e- he- 6 _ H t••• 1. ,,r, 31'�`�- _S�► ' of r e:S�'L:`i(r}71,tij t{ie i - GtlaYCarl'}�CGi '�c1 -i%-t T'• P -r-,- l Tv���,4 and utAaruFi-} y C;.4.f.patil ;-fio'--it,� � 1, / t4-1,-- a 5 f k F-G% k Bal,k`,atloi� w(1 i1`Gd._ '' N / C -i,..... r � su'r v eLss:d Aur�L; "r F; : �' `j ,`�i• - /� _ YA^{ �L,J .•JCJ*L- 'C°i �j�i'•1 '.i'cs'•?'y`i: