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HomeMy WebLinkAboutScharrenbroich 04 6,S:04 JUDITH T. TERRY ; Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR OF VITAL STATISTICS : Southold, New York 11971 MARRIAGE OFFICER e� tir Fax (516) 765-1823 ° i.° 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. 1637-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New X Existing Name Of Owner SCHARRENBROICH, INGO Mailing Address 1 238 WARREN STREET Mailing Address 2 City St Zip BROOKLYN NY 11201-0000 Property Address 1 HALYOAKE ROAD Property Address 2 City St Zip ORIENT NY 11957-0000 Owner Telephone No. 718-596-7227 Tax Map No. section 27.00 block 2 lot 2.009 Cross Street PLATT ROAD Date Of Last Pump Out 0/00/00 Issue Date: 3/07/91 Judith T. Terry Southold Town Clerk (TOWN SEAL) 5 • OFFICE" OF THE TOWN CLERK 'S�F. FD(,r / /'' Town of Southold � . = C'� '- Application No. /(O 37 Judith T. Terry, Town Clerk ":�� 10.00 - Residential Town Hall, 53095 Main Road � 4-. $ Cl7 y, �5t ^t�:�rV P. O. Box 117 9 �; .. � � ��_,. � � $25.00 - Non-Residential Southold, New York 11971 O ��� Telephone Q(.. `)\% .° (516) 765-1801 ' TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ DATE 1 /7 ye OWNER NAME: /A16-0 cc , 4-J.i f 6/Cfl' OWNER MAILING ADDRESS: 2-3 g./ S27-7- .41..90 OWNER PROPERTY ADDRESS: 4.7-7 k. 49 ®j 4 7 , JHca! OWNER TELEPHONE NUMBER: 7/r-- TAX MAP NO. : Section 02,7 Block 02, Lot 2-, CROSS STREET: 4-j-prig" . TYPE OF SYSTEM: Septic Tank New / Existing Cesspool 9/ New V Existing Residential Non-Residential DATE OF PREVIOUS PUMP-OUT: LOCATION MAP: Must be attached hereto before permit may be issued. 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ET,:k"-,,l4, .:011 )•:-'•0'- 1l0,-j;•4-'-''1/2-'1--‘,-•:'-z-.-,:•--...;--'4-.''.'-'H'.7''-'7--:-:c';,;-;..::c.:.:-:,..,.::-,::,j,-,.•:,., HOS!NT.'FWEOMsRSTMO. FT'°OURPPTH- . , -- :• - ,,--4--.i.'k'e ^ SUFFOLK CObEr * . ' • . • - •• ;•:::"'"4-T-PtD.F.FIT.,'O ,-..- ••'' ''--1,••• ••••--: •zt''':\, 1•:*, ,' • ', , 2.z'' •c".•' ''‘• ,'t.. '.' 4 v ,,,-•"s-,,7,‘''.• (I;.- .V. . ' , ;.',' ...,QIENTri'.:,''•', ' „,:::-_k,',,s,, ; - , . , ' APPLICAN -io ''-- 't,,, i ;i!.,.qt'•litiQ1-1 saiv[q...j.2,5 = '.-k' . j,-,,?!4.1 : I',4,T..f..„'..Tc‹,.r-rili';.,'•';--,.:' „ • - -,- '• -‘,,,,,', ,''',„-.i•i:',-;' ",'- 1 —, ', ''. ' -•-.-•• • ..,,,,,- ,,.. .,,,, ,.;_,-• .,,,,. ,'':` , , • '.., :.•' , " -•' ' t '‘f...-' ' ',-..Y.:',:T"›,,-,4' •• \ ,'-',' -• '. ----." •. - . .-`-4-1.4,4,4. -•-• .. ,.-ts....,„..-,`...,'-'•':‘,:b4,0 .,. • 1,,..N._".•- :•• .: ••;.,,,,'':',' ., ,.," - ,..."-,-....„;...,,-,3-_ - 7W19:Or,Pdtplic/L.4.07.r‘ii:1-L,.,:`--'• • '''- ' ,, -.. SUFFOLK COUNT 7' •-1..'4i;:'`.--•,,' : '-..". •'!''`-,.'1Vt.Nk..CCINiC.,)! 'is,' •-citi 1 '.. i 4,7'-'4' ''''. IP ' '' ' -''''' •-,." ' ''• ' '-- _ , . , ...i.35,-,•', .,,,•7 .•••.', •', -,, . ., - .'7''T.,t'•-'i L i•.' r ••:,,,. ` ... i • •, A -,, . • . • - ' . :,.',;?, .,•:,-,;\ s-- '., ,, • ' , ''.. '. • • '.-• ' 'SEP V IC E 5 -. FC ',' ''_.-,-",,-,'Y':-r','',-• . V•,.."''.".. - '..'' :. '' "' ' '2 ...: .',..'-,12.4;--..?.. I.,40.,..C.•--. 1 . :,. •-.1.',-.:-.. ..,, --- : -....::-,..--'•!- i• ...":'-ha- V .1 ir.t::: ": -'' , . ' ' , i• ; -' ,--. -,,- ',.,, •- v7-- - `, :•$•.':-- -' ,, 9 ,. •` i ':. . '; t,J SUFFOLK COUNTY DEPARTMENT OF HEALTIf SERVICES . 1 '4-- -,' ' --'•••• 77:-.7. ‘, ‘ , • , -.-T.'-'•" -$1f1OLT FAMILY DWELLING ONLY . . , , CONSTRUCTIONDATE01, ;‘ ...•- •7,-ii•--,•••5.••,.. --;-.•-it f'•• • , - •••:-.cV ' II f s'::-4..7 -=,'' ' ' - ''''' • . . . . . - . ,,,,-,47.1 1.,., ,„ ,-:,• p ., .-::` ,., ,r v a ,c .x_ . ... -• •.‘,. :.-, , . ,-- • .., ,:' ••-- ':. 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