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HomeMy WebLinkAboutPetersen 1OLKeoG JUDITH T. TERRY `O ` Town Hall, 53095 Main Road TOWN CLERK O ►►Z P.O. Box 1179 REGISTRAR OF VITAL STATISTICS Southold, New York 11971 • MARRIAGE OFFICER yQ o ,. Fax (516) 765-1823 �y NWIII 1. 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. 2058-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New Existing X Name Of Owner PETERSEN, JOSEPH & BERNADETTE Mailing Address 1 85 SILVER COLT ROAD Mailing Address 2 City St Zip CUTCHOGUE NY 11935-0000 Property Address 1 85 SILVER COLT ROAD Property Address 2 City St Zip CUTCHOGUE NY 11935-0000 Owner Telephone No. 516-734-5315 Tax Map No. section 95.00 block 4 lot 18.001 Cross Street ROUTE 48 Date Of Last Pump Out 0/00/00 Issue Date: 2/25/93 Judith T. Terry Southold Town Clerk (TOWN SEAL) ti r,. • OFFICE OF THE TOWN CLERK ��FFO� Town of Southold 0 -. CQG'_ Application No. °2 G�"� Judith T. Terry, Town Clerk 0� Lxif ft-- •�, Town Hall, 53095 Main Road *_ _ : " I $10.00 - Residential p. 0. Box 1179 —� v' t �' Southold, New York 11971 O ;�--, � � $25.00 - Non-Residential Telephone � 4° ��� ��• (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION • for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ DATE c::2 -c:23 — 3 p� OWNER NAME: .✓ 05ep�J '1 -eac-vla e OWNER MAILING ADDRESS: 8c- S; L. Ve r Co LI" /QQ' C-- %CIgO 693s— OWNER PROPERTY ADDRESS: SG=ryt --e_ 36i'TOWNER TELEPHONE NUMBER: 37 736i- TAX AX MAP NO. : Section Cj Block Lot / e. / ,-.CROSS STREET: kr-Z":7. �� ,S<L !/�� C-4 TYPE OF,SYSTEM: Septic Tank —New Existing Cesspool New Existing Residential X Non-Residential DATE OF PREVIOUS PUMP-OUT: /V P(/'e 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.) ignature of Applicant RECEIVED •BY: Town Jerk's ffice DATE:- ,•", • L •--1-,-----..-,K,--.•-,1 -,-,77-r, . , ,---,,,,, ,.,, ,,,,--,„,7-.7,..;,,.7-„; 5.1-„,,,,:-.'"'-;,,-,tr.,4:„.',*;'',;47t7-,,:.7-,til,',7-':','.:t7"4.-.;',.7:'-';'.'",'-:- ::'i'l':;f1:27-55'-*:`-_-:•:,' 'n't--'''.-,;%,,i'-'',-,"`i ."-''';',-;,..7,'-',,,, :.:.'"iilt:t'...:1-Y.::'11`,.,Y,K,;-,-k'.,-,-.g..,,,-teq,-,..,".7,,-,--„•-j,-.„,;".1,-_-_-.1,,,",,,-.,,3:,-,-_,,,,_-4.-2-0',4, ‘,..i.r•*7--1,--',-..,.. 7-,6-,,---,,'..-ek-_-Ji,t,.-'..."1-1--'er"=.'.-4,,..-,,i,-.'-t-'e,-'7.-;', 44",,',.-,-,'''''`-'',- '- C- '••••'`.,'-f% ,',' i.7.,-,V.,R.;'-4,-,,,-.1t,,,, ,........4-,,,,c,-,,, ‘''''',..4,1,,.A.P:Ni-,flg',.,,,,`.i;:‘,-;,',,,In.•1.-,k.^,:,,i';;•-:',..f,,:', 4,--'7,''''''',_; 1 . ',-ZZ:1-',i;,,;',i'.-‘,''''',.k•, 1".*:'' '2!.‘ ,.".;,''..- ," ,'„. ,,-'4,-,;,, ''''',.,..s,,' ..' ;,,'-',,,,,,'7- ",,;•-!•,,,,,73 er,.,.,',:,..yq.,,';:+,,,..^:`,,,,-'S 7:"i ;,',,,J,..',,,,i• '','r,l''., ' ,..,-,,..,,'L,,:,.X,t4;,'",,,,l.L..! ''',,,,:"..ft,';,',.,.:-CcI.:',:',i,,,1,,?, ";'''",'.:'.'-:1,•,';'?";",;',' ' '',; , ' . ' . -- ' 'k--:4',,,,4,',":,';',,,,,,'-f,,=,- ' , ' . . ' ' N-- -, '''C '-''t'J''','.'•';',`Y ''',' ' -.,';''' :',"' -" '', , 'c " ''',',.',.l'it',-."S.k--ttl ; ; - ,— „,, .'..i.,;-::.,-,-,-,r-,t-..'-';'4,,-, 't''•' ' -''' '-',t'-'r;'c''';'''`'il ,,,"...,..,,,,--•'--: ' .-- - ' , ' '-' t, ' - ,-,",, ; -- ,, , ,...,''..:,',,,,,'XI , ....... ,.., 'Co•k .• -1•21- 02 .•:,... %,..3 r„) \Z..... • / ., ef N. .; 0 '0 _, <c) ,...../X / ,.; LT CM / <0 e . , < 1 . 1 . V,... ,./ .. / •0 / / • • < "/0 k.... .., V / c-, %, ,NO* k. •5? '5:3 • ...,, 0 /' 0 4..., 4\1' 0• , 0- N.....--• . .. , . . , */,,,c•I , -r-z• %.9 , V' / . . •57 00 c3„,%, , - , / 0 k9 , • o A°, o• ,-s, 4,f, \ , v) // <,s•.„. '1?, ,, L - .0 A„ - \ . , . X OA 710 • ..-i•(</ o .72-tr V C o', / // ./ . v .. .* // . , 4' , . L=3 9.27 Pc/en p 0("ie.. /. , / / Ca Nf" . "" .....0 ry, A 0<_,se ,.., . / t / . . t/ ... . ) . I / \ 1...‘> . \ 6 . .2)— / / \k.is• ri/ • ,•,.,, 4: / 1 \ . / txo' / • • • -,, - - 0/ / • • \ / \ / •J \ / r0 / i/ • , . , + , 9/ sr.,No 6' • 0%. ' r .0 431' 0 . , r o c<o 06.. It. . /3 c.) , •/,„ / d's ..u• , - •/t9, , .•." 47 00\/ , ‘..a,_ 4.•\' ' v,.. .,- ., • 4... 4 .i/. t,1\\ 0