HomeMy WebLinkAboutGallo #11 OFFO`itC
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ELIZABETH A.NEVILLE % c .mac Town Hall, 53095 Main Road
TOWN CLERK 2 P.O. Box 1179
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p Southold,New York 11971
REGISTRAR OF VITAL STATISTICS ‘:#'1*
y '�� Fax(516) 765-1823
MARRIAGE OFFICER ;'0, 4; 0
Telephone(516) 765-1800
RECORDS MANAGEMENT OFFICER _ �i� P
FREEDOM OF INFORMATION OFFICER '•• •'��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3814-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner GALLO, ALFRED M.
Mailing Address 1 80 GARDEN COURT
Mailing Address 2
City St Zip SOUTHOLD NY 11971-0000
Property Address 1 80 GARDEN COURT
Property Address 2
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 516-765-1825
Tax Map No. section 63.00 block 7 lot 17.005
Cross Street WELLS AVENUE
Issue Date: 9/11/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
OFF1Cii OF THE TOWN CLERK %S1FGU( '
TOWN OF SOUTHOLDper. .CD Application No. "fig
ELIZABETH A. NEVILL1 ,TOWN CLERK ' ~ ' 1 �� $10.00 - Residential ��
P.U. BOX 1179
" �, $25.00 - Non-Residential
SOUTHOLD, NEW YORK 11971 � p yl=•p�0�.��
Telephone „c •
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No3 3
Fee $7O1.00
DATE /'' /0 ` r
OWNER NAME: /atFRn ifq . GALLo • •
OWNER MAILING ADDRESS: FO 61i7QDEp J COUR
SoUerf+OLD, tu.V, ( 1coI
OWNER PROPERTY ADDRESS: SOME
OWNER TELEPHONE NUMBER: 576 "762,6"-^/ � ,5"---
TAX MAP NO. : Section 06:3 Block (37 Lot I 7,5-
CROSS STREET: 60,0.. /c-- i(hie____
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool 7New 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.)
in , ,e(y) A Or',
Sinature of App scant
RECEIVED BY:
Ti i .
n Clerk's Office
DATE: ?/0
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SURVEY FOR
JOSEPH G. CROSS 8. MIL DRED C CROSS
LOT NO. 5, 11 SOU THOL D GARDENS
MAY 24/984
AT SOUTHOLD DATE, OCT. 7, /983. '
TOWN OF SOUTHOLD SCALE: /"= 40'
SUFFOLK COUNTY, NEW YORK NO. 83-866
N UNAUTHORIZED ALTERATION OR ADDITION TO THIS GUARANTEED TO:
SURVEY IS A VIOLATION OF SECTION 7209 OF THE
NEW YORK STATE EDUCATION LAW AMERICAN T/ .-V'i VR', . CO.
N COPIES OF THIS SURVEY NOT BEARING THE LAND S1•
A-
SURVEYOR'S INKED SEAL OR EMBOSSED SEAL. SHALLPRD �y 9
NOT BE CONSIDERED TO BE A VALID TRUE COPY y1 } ...
)(GUARANTEES INDICATED HEREON SHALL RUN ONLY TO �O ,`1:,..--- OG
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE PERSON FOR WHOM THE SURVEY IS PREPARED4.
AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERN- g-.
N NEAREST WATER MAIN_MI.4 *SOURCE OF WATER. PRIIMTE_PUBLIC •." MENTAL AGENCY AND LENDING INSTITUTION LISTED • 1 y'6' 1" 0
N SUFF CO. TAX MAP DIST 1000 SECTION 043,BLOCK�1-LOT 11.5 HEREON,AND TO THE ASSIGNEES OF THE LENDING 4 i
NTHERE ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE f 4.I i'
OTHER THAN THOSE SHOWN HEREON. TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT
N THE WATER SUPPLY ANO SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE OWNERS :_;-- .1. •' .tid 5 ....-5�v, �.�;
' WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT *DISTANCES SHOWN HEREON FROM PROPERTY LINES Te
OF HEALTH SERVICES. , TO EXISTING STRUCTURES ARE FOR A SPECIFIC WJE %;
APPLICANT' PURPOSE AND ARE NOT TO BE USED TO ESTABLISH Q LAND WO'
PROPERTY LINES OR FOR THE ERECTION OF FENCES
ADDRESS
TEL. : • -YYOUNG A YOUNG RR VERHEADN DNEWiYORNK E
NOTE: ■ = MONUMENT , '
SUBDIVISION MAP FILED/N THE OFFICE OF T//E CLERK OF ALDEN W.YOUNG,PROFESSIONAL ENGINEER
SUFFOLK COUNTY ON MAY 7,/979 AS F/LE NO. 68/2. AND LAND SURVEYOR N.Y.S.LICENSE NO.12845
HOWARD W.YOUNG, LAND SURVEYOR
*THE LOCATION OF WELL(W),SEPTIC TANK(ST)II CESSPOOLS(CP)SHOWN HEREON N.Y.S.LICENSE NO.45893
6 ARE FROM FIELD OSSERM1TIONS AND OR DATA OBTAINED FROM OTHERS
a
BC.ANDIS & SONS. INC. 1618 • •