HomeMy WebLinkAboutFleming JUDITH Tt TERRY ' Town Hall, 53095 Main Road
TOWNCLERK ` f P.O. Box 1179
REGISTRAR GG VITAL STATISTICS Southold, New York 11971
MARRL GE OFFICER � ;_ � Fax (516) 765-1823
4.
® } 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. 1882-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner FLEMING, EDWARD L. S JEAN M.
Mailing Address 1 RR1 200 LESLIE ROAD
Mailing Address 2
City St Zip CUTCHOGUE NY 11935-0000
Property Address 1 200 LESLIE ROAD
Property Address 2
City St Zip CUTCHOGUE NY 11935-0000
Owner Telephone No. 516-734-5627
Tax Map No. section 97 block 9 lot B
Cross Street SKUNK LANE
Date Of Last Pump Out 0/00/00
Issue Date: 4/15/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
• II /I-
01 PPCF OF THE TOWN CLERK c3uFFU(1(r�'-
Town of Southold CQ Application No. /
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Roadt /
. .•C 7 $10.00 - Residential V
' �; ,
Ft O. Box 1179u' 4MG ;: n�;' $25.00 - Non-Residential
Southold, New York 11971 O t /
Telephone .( * '�
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit
Fee $
DATE it
OWNER NAME: 1QCcc c/ ,,� ) J a /41 / /emi r7
OWNER MAILING ADDRESS: R „ A -2o6 /-ec/re•
� -17 O n v /l f3
OWNER PROPERTY ADDRESS: jj O /Le5'f
rt.`1-c_ 1 coc., c?m
OWNER TELEPHONE NUMBER: 73 4( 3 (E, .2.-7
TAX MAP NO. : Section 9.7 Block 9 Lot dirio
CROSS STREET: irun L,3
TYPE OF SYSTEM: Septic Tank New Existing x
Cesspool 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.)
P(--
Signature of pplicant
RECEIVED BY: i , l
Town Clerk's fice
DATE:
L Il SI!!yT�
I I
l
;L
lo-,�-
I
4'L, O
10
OC'
sem:-
'-^.LL. E' .G
LE J r --k--.
) _
OE
150 O
Dy ',I
/ 5,,,-b„,..,
',\ ,
,,\-,.,-,„..„.„..,....„...,,,
,sol ,,,, ,,,,,,,-/-,:-,::,.),,:
j,
s
,,,,o 5° V' `V r \ '
,`„)(7.,t
r—
ti ,z
,I
N
,gar
o`D `
qcp
/
'fkis/
/ BII
eo
I' IID �._--.._,,,,-
• I c 9a
ha It
fern •
WL
CI h N
Q4_- v° 'P
CT lc
Pe
Lot \`
a'
3.A
,33
co
o- SKS
0930� V,J•1o�
551° 3.
t / Peter
NOTE'
• U MONUMENT / rtof NEW rDSUBD/V/S/ON MAPF/LED/NTHEOFF/CE AyO'RFOF THE CLERK OF SUFFOLK COUNTY ON1 ' ''*✓UNE 2,/972 ASF/LE NO 5723. sc
a
6
PSS,A'o I 2.,,,,, Flo
/�'YAL ENEII�`e`
REVISIONS YOUNG & YOUNG•
rte'
400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK
ALDEN W YOUNG HOWARD W.YOUNG
PROFESSIONAL ENGINEER AND LAND SURVEYOR
LAND SURVEYOR N Y 5 LIC NO 12845 N V S,LIC NO 45093
•
HW. L-
AUTHCED ACRATION DR ADDITION TO SURVEY FOR
T
IS SURVEY ISA VIOLATION OF SECTION EDWARD L FLEMING 8 JEAN FLEM/NG
72209 OF THE NEW YORK STATE EDUCATION LOT NO./,'BAY HOMES"
• COPIES LF THIS SURVEY SAP NOT BEARING
THE LAND SURVEYOR'S.5550 SEAL OR
EYBOSSEO SEAL SHALL NOT BE CONSIDERED
-O BE A VALID STUD COPY AT GUARANTEED TO
PECONIC COMMONWEALTH LAND T/TLE/NSURANCE
OJA91NTEES.VCICATED HEREON SHALL RUN CO OFNEW YORK
_-_- loo"-:oN FOP MNDIY SNE.A TOWN OF SOUTHOLD SOUTHOLDSAV/NGS BANK