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HomeMy WebLinkAboutRedfieldJUDITH T. TERRY TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 3191-R Residential X Non -Residential Fee $ 10.00 New Existing X Name Of Owner REDFIELD, HOLLAND L. ------------------------------ Mailing Address 1 P. O. BOX 941 ------------------------------ Mailing Address 2 ------------------------------ City St Zip CUTCHOGUE NY 11935-0941 -------------------- -- ---------- Property Address 1 2145 WUNNEWETA ROAD ------------------------------ Property Address 2 ------------------------------ City St Zip CUTCHOGUE NY 11935-0000 -------------------- -- ---------- Owner Telephone No. 516-734-6765 ------------ Tax Map No. section 111.00 block 8 lot 2.000 Cross Street OLD MENHADEN LANE ------------------------------ Town Hall, 53095' Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1801 ---------------------------------- Issue Date: 4/14/94 Judith T. Terry -------- Southold Town Clerk (TOWN SEAL) 7 QFF?CE OF THE 'TOWN CLERK ` `I Town of Southold Judith T. Terry, Town Clerk Town Hall, 53095 Main Road P. 0. Box 1179 Southold, New York 11971 Telephone (516) 765-1801 TOWN OF SOUTHOLD Application No. � $10.00 - Residential $25.00 - Non -Residential SOUTHOLD WASTEWATER DISPOSAL DISTRICT Operation Permit No. Fee S for OPERATION PERMIT SEPTIC TANK or CESSPOOL DATE �, 1 l rl `t OWNER NAME: A) r - OWNER MAILING ADDRESS: OWNER PROPERTY ADDRESS: ?; OWNER TELEPHONE NUMBER: TAX MAP NO.: Section Block Lot CROSS STREET: 0 I mef-) hczz�Zh ley TYPE OF. SYSTEM: Septic Tank New Existing 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 rnad _ ) RECEIVED BY: Town Clerk's, Office DATE: �a Signature of Appli&dnt Lot l64 200.0 N It E ATI 0.14 OR ADDIT10k 0 THIS'SLikVEY I * VIOLATION OF,/ `rte ll 1 1014 7209,10 T I[ NEW YORK STATE CAT46N'L , - ,, 0.IES OF`TI ill S/� LY MAP WOT BLARING H Ld�D SU'VEY ','S WwLt ,W (AI MICSSW SEA'- SHALL NUT C�-. CONSIDERED 0 BE A, VALID TRUE COPY. W RANITEIS INDICATLD 111PMN SHALL PUN 'FOR V,',,Cjte. THE SURVEI-' )'.,.Y TO TH- 1rSCN S REPAM, AND ON' HIS rl,LIALF TO THE f1T.E,comrA;,1Y,' GOVERNMENTAL AC1MY AND '.Et, ?ING-I,\-SfITUTI0N LISTED HLF.LON, AND FO THE,ASSIGNEES,OF THE LENDINd WTI- 5 FU [ON. GUARANTEES ARE NOT IRAMSMl .0 AD6Q0N4 !t4STITUTIONS 6i 'SlYSSEWENT -5, are, 6houin 8tj,ded Mac Wo, f,.- .5 a0, ou 0cp HO USO ADD J -P ou 5. M 36' Z 6 W. Lot 1,6 MAP CSF' P1210PERTY SuRvcyGD po-c 11/Au-5.A` U "k Say i Ktj s To "!N ar 6o V,7W -0 Lo, N. Y, CO.00 6 V. oC] A�iornuFrter•�f .ICG! 2 �*Mk*The TWe su.1panted -ru I//- d 5 .0 Iv V used Lan d