HomeMy WebLinkAboutStandley 4FOLK
JUDITH T. TERRY � Town Hall, 53095 Main Road
- �' "�
TOWN CLERK : cm2 P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS �VA,„ � Fax (516) 765-1823
MARRIAGE OFFICER �®�.�se Telephone (516) 765-1801
We
RECORDS MANAGEMENT OFFICER _ 1 T •l
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. 3277-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner STANDLEY, ELSIE YOUNG
Mailing Address 1 P. O. BOX 3524
Mailing Address 2
City St Zip HOLIDAY FL 34690-0000
Property Address 1 480 GRISSOM LANE
Property Address 2
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 813-861-7529
Tax Map No. section 78.00 block 1 lot 29.000
Cross Street GLENN ROAD
Issue Date: 11/15/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK cwFFUG��'=
Town of Southold &,Q CQG Application No.
Judith T. Terry, Town Clerk , r , t..41\
,, I
Town Hall, 53095 Main Road a l�t` ;�, ry°Y,�: .
.G $10.00 - Residential
P. 0. Box 1179 c.ri ; $25.00 - Non-Residential
Southold, r`� `'" 1
New York 11971 O - �`
416
Telephone -770..'4%. `�� I
(516) 765-1801 •
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ /O. Da
DATE V f
OWNER NAME: S( € O Ofl) h,
OWNER MAILING ADDRESS: pn , 0 )( 3 S�
��. `I 'I) 34650
OWNER PROPERTY ADDRESS: ,1, Co Y'1 ccO _ k
Soo -rhofdf fi) �y-
OWNER
e TELEPHONE NUMBER: (3 - 9C0 (-
-f-r
TAX MAP NO. : Section (��joiicisyr Block / Lot :3 3
CROSS STREET:
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 road.)
Signatu of Appl{rcant ' I
RECEIVED BY: lg
Tow Clerk's Office
DATE: ///7/97
izS.• `�L„ �3.f¢" -iy� •_ .; _�.r {t n„itae``K 't?'yg
=
f r`•;-+
-
r.
\\\\
_
4t_... -- — ----•••9t ''j_';'_- _ _. — -- ? !'" ^ ,.•�‘ \• 1rKh r � .. '\ 1. ; � Xi Yw > y , • ' '` — + r ,"-'4,,,, r 4.,-.4:4 ; y . rs_ • y3ter
I\`D_ .lta.5 s" ' " ^
•
. : - i, yl ugs :-: ,,, \t,t Z3 E , ^ .ti �} "� � i- sir'gyi31
, ^'Rf rr � c 9. _
4-{-, .- !'• • w
y
I / W l --_ ,-t , '-N.) - fi�� cle '
47
t, � - t _ °;' � r ( \ ; x
, ...-
'R/ � fi � "'/ �t, ar � .�11 " tcO C pCr.) •wen IT
r �°'tsr �'r1a - {1----7-_________,___Town eas met;-f ,
i` ''''' D \..`'-� z %� overtreat roord.irac ` "§ ? .
t4t1L' QT , a 'y} 3
f 4.../ C� / 1 . Q•O ti k' 0:O a.-0:;,, �f„
Z.C'
) • �;
/r .Z r-re- e :- E-57 et '.-y'�t ,. ti{ lir: ' e4,,tit 1- �e A/frin„,`ber- :38 '8 ? S _ H
_ \ , -
Scale �,D__11 ✓i - -.
•
'X C,— D - 7 �-- APR 171985')
, Are-a- 4O 8?3 s..-4.:-` - K. ,. �� .r ',
! / The sewage disposal and eater, supply `' I` �
_ YQLiAJ
4�._. .'C' -� facilities for this Iodation have beta � '�� ' ` �r , '
• AT
inspected by this d•pelteent and toxad - I -'' '
to Ila satisfactory. �r"' 17 "�
SC�UTr'OLL � /�, ewe sit"$e PE. - . R �`
ral X�inaert .. �' ,
5erx+ioel_ • _ •
'
/ / / 1 ! 2evi ed A�•,r. 8 (985
1‘,/, -- . L1J''/c SS 0ilie r:.,1;_ /r1 i ,2 ie(4, /07 i;'G.c ,vAers sho v' y �2 ,/t-r '"�'�'' • ts . ; x {
, - r -/'?") �r/ Y J! p i,T^ •-..1 i '`". .ice`t HL' /! o vs,i a -- /,// d l t� - + ` f`
-.;-/r,,V..-:>_ C {f?�' .�f Y l�' o� 7'- -,f `a S map �!f 6'lI fj Y v�3,57-
mapped � b. 1�, 1983 1 - -:K
ca Y �1, 5 .^ 1 ca I'1/r) r elf r 7tr� a n ale v a 7 --> •a-). to ° f�QOE (C1C VAN TUYf .' P, G. ' s �� �• ` ` ;�
..--, , ....-2 , r. a - mi c pitrrq h,' � ula-Ici' !'`3`?ar'k ltJ G0005( CreeC, �. Liorrs�d L�+ac1 ,SUry ors . = , Y ,T "'
. . . , /- 4%‘,2-eit.,..t.66trita,,e'44fiz ..-,:, .
Greer7'..r+ --• • - flew York j - . '
8
d A- ti-/4ior cr W L.ewciudowslci;L.S.
y