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HomeMy WebLinkAboutRive li OFFOLt ' Off' OG JUDITH T.TERRY ��� yet Town Hall, 53095 Main Road TOWN CLERK ; 2 P.O. Box 1179 w Southold,New York 11971 REGISTRAR OF VITAL STATISTICS ®� MARRIAGE OFFICER 4 O��i'�' Fax(516) 765-1823 RECORDS MANAGEMENT OFFICER : ,� � 4, ��, Telephone(516) 765-1800 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. 3504-R Residential X Non-Residential Fee $ 10.00 New Existing X Name Of Owner RIVE, ANDREA Mailing Address 1 6175 NEW SUFFOLK ROAD Mailing Address 2 City St Zip NEW SUFFOLK NY 11956-0000 Property Address 1 6175 NEW SUFFOLK ROAD Property Address 2 City St Zip NEW SUFFOLK NY 11956-0000 Owner Telephone No. 000-000-0000 Tax Map No. section 117.00 block 5 lot 5.000 Cross Street OLD HARBOR ROAD Issue Date: 8/22/96 Judith T. Terry Southold Town Clerk (TOWN SEAL) a 0 '- OFFICE OF THE TOWN CLERK �FF0L -outhold �� Town of SApplication No. Judith T. Terry, Town Clerk �A ;. Town Hall, 53095 Main Road ' " ' ' $10.00 - Residential—"� P. O. Box 1179 crs 1' �, t.'° fin ;' $25.00 - Non-Residential Southold, New York 11971 O ® "s"144 � Telephone ®j (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL - Operation Permit No. Fee $ /0 .61-D -DATE .7(o OWNER NAME: k2& r2vv- OWNER MAILING ADDRESS: 17 I /m> J iPf-C i 1 w w gum OWNER PROPERTY ADDRESS : /e( Otbrkl OWNER TELEPHONE NUMBER: VNafkJ TAX MAP NO. : Section Block ,5- Lot `5 CROSS STREET: (met (45/11/CE/q7-5)TYPE'OF SYSTEM: Septic Tank NewExisting Cesspool New Existing Residential Non-Residential 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.) att..41-4,14, Signature of Applicant RECEIVED "BY: Town Clerk's Office DATE: . - f . ,1 • - — • ______. _,......___. ----. -- — 1 ,. , • f . ..1,..c ' r- I . ;c) u • ' • ',.. NF GLA.ics v 2 0•:. . , C 7-- 1 . . 1 ' _ ". . • . I, - ' , E. -.S.8 3 1 0•CO- , , . . . 1-GO:7 - 1 .. . _""....-G, • .. . - --....--- .-.......- - -.- CAE DOG RUN - .., ,...0 , , Tat.ACkT9P PIZtVE i • ‹;- PJ- :-...G.4%.2. . • ' ' . ,, 3' ,, ,,, . , 2-;--1r, , . _ ._. _ __ _ . _ ._ s. .... . . • . _ ,. , „ . , Au k.) , ' •-.5 , I i ' 4 d , • ' .. , A to ,, 4-.. n- • , „ . ; ••• • . , •i ., ; c• , - , .- .. ' t 0 ._ i ,- _ . . „ CE'SS. POO)L5 - \ \ . }EI<Lli.' i . ..... 1, \‘ 'S0,C4,z8,YP,LI PEP.sE- e r71cTAk / < ‘ 0CIPM T i1 N... ....., 'Vj I ' 1........ 1 . 1 - o,,...:,,_ .7,„ 1Hol-ol .:J. 1 frue ,ki ' -.I Ln I 1 ..5-102.Y EQ HO --2.- ' - -- '0313 AC, ' -., • - ..7 . 1 -. I'• i I L •01 ti.1 • / : , .' . ,-..-... -4, , , - • , , _ , ,.. .._ . , .: i ,, I . • , , , ‘ .2,..., .,,ici . . - .,.;._ -! ' i - , DY '6 GACZ. i - 1 • e 1+1„ ' I . .. . - 011711 -•V .1! - iu ' - ' , _-..... I I , o0 - ../ 39 —..-:_71' • •r-7. . 1- .0 .. . . t3LAciP,cro - bRIVE , '-1G-t-5m' i , . . . . • ' ______ _ _ .___:..: .____ _____ _. ....._, ..„....._. __LL _....,___ _1 ,..., -7.- — 1__.1------,7--.^1 -:---- - . , — • SU FE CO-TAX MA P...DA:17\: [CVO--1-t1-5,-5 I ' ...-, , o , • „_ , . . .• i . • T61.5.3 ' - • i . •/''. , Ki. .55, 30_ , , . . . TITLE 0 0222_ i-i.,09:11-Vt ' ' ' - . .. . - ' , - . . . _.. , . . • . .- . . . . . , . . • • . ,. . . , . , - ..'• i -N _F ..-,FOTE12. . , I - .. , . . to ' 'MAP ,OF PROPSTY , , . . .. . , . . -, •...__Gf,, EO3.. .1., - N . . , . . ,.. . . .. , 5UWRVWEYK5t1.E7.‘)FDROL.f.e: •. • ANDPFAGOODALt 0. V LTITLE . . • INSURANCECOCQLUMA FEEPNL5Avt75 BAk ., - • lAr2 ,193 . , . • • . ,,Irt,V0''S'P"`a*'''''.,t% - ,.".(if NEr,i7--, " i , . .. , ',..:4-a:-;-1 sh•.11;rv.3',t,e c. , , _,z.," .00( VAlif `(3_,p‘ .,., TOWN, OF 'SOUTH°LA) N.y. - DiERIC,14 VAN TUYL PC. ' _... ' • " . ' . c,,:,..,,-,t,,..,;„. , .,,,,,,,,, ,,,,,, -,,,,,z ,,, 1-;,'\ ibi li c- . , - 0 ,t.,„ . • ., ..4. -ti• 1, . ' l'' ' . , , • " . , '1-k' ''10.., '•,,r ' •:t-FOL.1"i' p;, . . : - „., i...,...., --0-'17.----Rs . ' ‘,,--,-- -- • . ..,' ' co - , •-,•C,,,'Po' - ,,I, •,t.'I' . ,a, • I S 25`-' , - . - Ltc.LAN it) sut,z-Y *01as' - GrZ P'IP'C)174-1.- NY' , , ' ' ' -41)L AN0 - - . . . • . . , , . • ' ,-; ' - . - . , • ' . _ , _ , ' ,1. _ :-...,,z.,:,,,.. ,rin.. ::, ,hn..i.,,!,,f ..,., ........,_, - i 1 . . . . .• • .. • ,, • • - ..........,—____ ......._.„ . , ,. ,• . i , .. -".. .,-, ' . . ,• • _.- .- -, • , ' . - .. „