HomeMy WebLinkAboutFitzpatrick •c5IF ULi t
JUDITH T. TERRY ; .4 It Town Hall, 53095 Main Road ,
TOWN CLERK Z p T P.O. BOX 1179
REGISTRAR OF VITAL STATISTICS N S� Southold, New York 11971
MARRIAGE OFFICER �Q O�r� • Fax (516) 765-1823
IP r• 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. 2038-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner FITZPATRICK, MICHAEL & JANE
Mailing Address 1 283 AVENUE "C" APT. 9D
Mailing Address 2
City St Zip NEW YORK NY 10009-0000
Property Address 1 5285 PECONIC BAY BLVD.
Property Address 2
City St Zip LAUREL NY 11948-0000
Owner Telephone No. 212-677-3003
Tax Map No. section 128.00 block 1 lot 19.000
Cross Street BIRCH DRIVE
Date Of Last Pump Out 0/00/00
Issue Date: 2/22/93 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
-41
OFFICE OF THE TOWN CLERK .3\\FFO /
Town of Southold �� CQ Application No. 27d ,"
-40 xu
Judith T. Terry, Town Clerk :..
Town Hall, 53095 Main Road $10.00 - Residential
O. Box 1179 v' $25.00 - Non-Residential
Southold, New York 11971
Telephone 4214Y►
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
- APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ /0 —
DATE /14V Z O /9 7 ?—
OWNER
OWNER NAME:Ave/A 8 d 0-0Ad E' / T2/,•92700<
OWNER MAILING ADDRESS: . 3 g tie a. - / ,7- 90
�. y. C, ooti . `I, / d c/a
OWNER PROPERTY ADDRESS: 6a6P,.' 8.37
> �PCo.vFG
A. / / /✓• y. /1 5 n'
OWNER TELEPHONE NUMBER: - E., /2-3 a a2
TAX MAP NO. : Section /a—d— Block • 0 ( Lot / !"
CROSS STREET: !3 i a e .0/21-1%r
TYPE OF SYSTEM: , Septic Tank "Z?=•- - Existing (I-2-
Cesspool / Existing
Residential ✓ on-Residential
DATE OF PREVIOUS PUMP-OUT: /rO '—/ 5sa-
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.)
igna ure of Applicant
RECEIVED BY: �1
Town Clerk's Office --
RECOVEry
DATE: - -
7(m-,
TrrAiri Clerk Routlfold
/
nAU1HUKIL[U 4LItKAI ION UK AUUII I._
% - O THIS SURVEY IS ATHE VIOLATIONNEWYORK OF
>ECTION 7209 OF STATE
\ -DUCAT ION LAW
�`A - COPIES OF THIS SURVEY MAP NOT BEARINI
VyV THE LAND SUkVEYOR'S lhiKEO SEAL OR
(� .MBOSSED SEAL SHALL NOT BE CONSIDEREI
�Q �Op Q \,....N
�\( 10 BEA VALID TRUE COPY
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\ 3O kNNNN4N •10((�� t ,)TTON GUARANTEES ARE NOT TRANS}•RABE'
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a ,�4j NOTE:
v ? o=MONUMENT
43/ a, °4,--3‘c0-1---,_-__. a`4�' =STAKE
Ai ti ' °4 <5, /\'►� O SUFE COUNTY TAX MAP
\ .1 a ?s �O p �� DIST/OOO SECT./ZB BL.O/LOT/9
• �( Go(Q �gR\ ' ti,• nl ,koa �SB a. O� h9 1
40 ,�\0 �� SS1� r. •�i .��\\ ,� \ � REVISIONS lo e YOUNG & YOUNG
O( `JG �vP' ?y3 ��� � e �� O� 7 AUG.22,1974 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK
C�� - ,„ h� NOV. 5, 1974 ALDEN W. YOUNG HOWARD W. YOUNG
GO _ 6 _ NOV. 6, 1974 PROFESSIONAL ENGINEER AND LAND SURVEYOR
\'O / .•/ SOB/ �� �' DEC.26,1974 LAND SURVEYOR. N.Y.S. LIC. N0, 12845 N.Y.S. LIC. NO. 43893
v ��o ' '- _ I JAN.23,1975
e o oa6 \ MAR. 19 1987 SURVEY FOR:
e°� . �� MAY 25,1988 MICHAEL FITZPATRICK 8c JANE FITZP '' N��v v
�5 ��i�o w. Yo�� ��
.-AN �&�1 #T :. 1 i
` \\ AT LAUREL u§L.'"E TI 'i :`-[{I3DRANCE Ctk.OF N.Y.
/GO` _ •F'IEA .. fIf
TOWN OF SOUTHOLD "`a ®' ' '
t ^
BY e. s 'V '" ,s
SUFFOLK CO.,.N•Y• �y/; j ,. ��
�> ' i SCALE: I�1 _ 401 DATE: OCT. Z6,I9 2- 844