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HomeMy WebLinkAboutFraser • © =ar gra Town Hall, 53095 Main Road $g53 ' P.O. Box 1179 "6. ` Southold, New York 11971 JUDITH T.TERRY �i�� FAX(516)765-1823 TELEPHONE(516)765-1801 TOWN CLERK 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. 1372-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New Existing X Name Of Owner FRASER, CAROLINE M. Mailing Address 1 240 ALVAHS LANE Mailing Address 2 City St Zip CUTCHOGUE NY 11935-0000 Property Address 1 240 ALVAHS LANE Property Address 2 City St Zip CUTCHOGUE NY 11935-0000 Owner Telephone No. 516-734-5614 Tax Map No. section 109.00 block 2 lot 4.000 Cross Street ROUTE 25 Date Of Last Pump Out 0/00/00 Issue Date: 1/29/90 Judith T. Terry Southold Town Clerk (TOWN SEAL) O'FFrICE OF THE TOWN CLERK , cAwFO(,rI Town of Southold Q C'� =• Application No. {/ 3 2 Judith T. Terry, Town Clerk rb ► $10.00 - Residential Town Hall, 53095 Main Road ,V, - P. O. Box 1179 cn x r,,„ �y � -.t ��1,:�. � $25.00 - Non-Residential Southold, New York 11971 4 `® • = �J Telephone o,( ' (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICAT ION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ • DATE // OG'� OWNER NAME: egiefDLjva/e /-2d-16e • • OWNER MAILING ADDRESS: .02 /9-4/, . `,i/V,� e,t,t; )1 V°//91c OWNER PROPERTY ADDRESS:_ ,„‘„ao OWNER TELEPHONE NUMBER: 5 6 73V-15Z/f/ TAX MAP NO. : Section /0 1 Block p-- Lot Q 7 CROSS STREET: TYPE OF SYSTEM: Septic Tank New Existing Cesspool X New Existing Residential x Non-Residential DATE OF PREVIOUS PUMP-OUT: )1 WV,etc 4.942( 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.) aqmae_ G gg.40' Signature ofApplicant RECEIVED BY: own Clerk's Office DATE: / /0" 7 / 6 j /` r 497z• _ MAP OP' PeOP82-7"Y citiP . I 5LJ VEYEO FOO 4- • C2OuN8f1.. F CL Tcf_ u T. .wq�i3O,jLc0 ALTf.�AneN Ufi wOrn�R•°' ' . ,1 - �'' f. �.y.� �_ J�/ f0 MIS SURVEY IS A VIOLATION OF ' - i - �i oWEV Q� Tlic:XL ;N L« SECTION 7209 OF THE NEW YORK STATE' , EDUCATION LAW s ` •- r - COPIES OF THIS SURVEY MAP NOT BEARING . '� .MC Ate- E .. - I - - THE LAPD SUVVE'OR'S EN:.D-_EAL OR .EMBOSSED-SEALbhALL t-CT:e CONSIDERED - //-- _• _ = TO BE A VALID I+U...c-FY ' N 41.54• " t GUARANTECS N J A x?• - 13�L44 ONLY TO TM, al Sit t' Rf I/!te RT I IS LEEPAI;ED. +-'= a , i.` , TITLE PANDA*.Y ' ‘.'7..,.''-Ist • o.4 E, i I ll G.3 N. LENDING iidS e,'u.,_ �; - Ig. .i _ C - i_ ,,. /* TO THE A:S.0 w:ES :r - , 8 W L + �i� - V� �"t, • TUTION. GUafhT-Z »,• 1,4;1, RA' ..� ! S Ok TO ADDITIONAL INSiITu;.'.N OR_C 5fr�;i�• 't � _ - , 4� OWNERS. _ ,1145 5450• ��, Ct• t. C _ OIt f uses '- . - • ;-' -', - m . sce, :3o-=[" , � si� `� `' , �' ort-arr fir' ;41.1 ' (ii - i d ci-leberi bkid bit* gragel. - /2 th,- : Y: tI\- i a., ili . 0.4 AL . Ila " / K-64('. ,l- O , ,._ ,. :a i OD y r aP'�'! r"t!! KQt�7Fdas 1 r +� E7Ct�t^CTrt!` { fdlL' .. rt A,,,t�yuHflurxg0.r4,0 m _ ; ; - . ' . -' t. 5.t. - re my �� r�Lt ..� �j,ass°=OE.,r►vaic�wa�Jul,. ` ter,r9�. .544, ct� C.o•Tarr Mae' Aesirisin`joK: _ - , Ip QQE ICAC--EVAN 77.-net- ,P C. , .� x. D'a�: f �Q9,�/oCL' 2�1�►t44:�r .:r,`._ s �P Y �•..+.::�1"s' 1� E .is.' _ r -. Licazn*eo(Land'5�vt+yov-S , qV , - _• • _V,_ _ : , _ . •G'rl�rrl,Orf" -- New YO? V • I .� ` - i - -