HomeMy WebLinkAboutSullivan (3) ,00000O, "-a
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Town Hall, 53095 Main Road
aJ, P.O. Box 1179
'ItQl * A01. Southold, New York 11971
JUDITH T. TERRY _�_.w_ //O.° TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD •
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 1097-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner SULLIVAN, JOSEPH M. & ANNA
Mailing Address 1 3095 ELIJAH LANE
Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
PropertIy Address 1 3095 ELIJAH LANE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-5086
Tax Map No. section 108.00 block 4 lot 7.018
Cross Street REBEKA'S ROAD
Date Of Last Pump Out 0/00/00
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Issue Date: 5/05/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK c FO
Town of Southold ��..:<5�. CQG; Application No. /0 77
Judith T. Terry, Town Clerk 44x ; y
Residential
Town Hall, 53095 Main Road
P. O. Box 1179 v' z Non-Residential
Southold, New York 11971 O � •1`
Telephone j
•
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. /0
Fee $ /O gs CO
DATE sbic-6--
OWNER NAME: - Sk Q(� Sv-(lf(fkk�k '6 (--1-Nt\kfk
OWNER MAILING ADDRESS: c3 OE. f a'14-4
c r` r
OWNER PROPERTY ADDRESS: £ A-M 4s /1-73pl t
OWNER TELEPHONE NUMBER: 2_,9'T—c...5-0 Cp
TAX MAP NO. : Section Block Lot
CROSS STREET: IfP (4lc ` O If\( ( Q 1-1 czr.- RT-• 2.,S—
TYPE
TYPE OF SYSTEM: Septic Tank New Existing }�
Cesspool New Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: � (��� C�� e "�({e QW1 VOAPOZST
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.)
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a�of,Applicant
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RECEIVED BY: a �
Town Clerk's Office
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DATE:
MAY 0 5 1j-9S
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ELI JAH'S LANE
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. ELIJAH'S LANE ESTATES "
Unauthorized alteration'or addition to this survey is a Violation of
section 7209 of the New York State Education Law. ,
Copies of this survey map not bearing the land surveyor's inked
, seal or embossed seal shall not be considered to be a volid copy. ,
.,vc;_n?e s or certifications,indicated hereon shall run only to the
All distances to wells and cesspools are person For whom the survey is prepared,and on his 6etialf to`-the--;
title company, governmental agency and lending institution,listed 'A,
by location from house owners and field hereon,and to the assignees of the lending institution. Guarantees
observations, since most wells and cess- or certifications are not transferable to additional institutions or-.
pools are .not visible these, dimensions
- cannot be certified. •. subsequent owners.
SURVEY FOR REFERENCE j - •,W
M
JOSEPH, ANNA SULLIVAN V ELIJAH'S LANE ESTATES SECT.I • -
,MAP NO 6066—FILED 2/14/19744„: -
AT MATTITUCK . . ,
-TOWN OF SOUTHOLD' ' . . , GUARANTEED TO'
SUFFOLK COUNTY, N.Y. , ` ' JOSEPH 9 ANNA SULLIVAN ' -
AMERICAN TITLE INSURANCE COMPANY. ' .
SCALE ; 1"a 40' SOUTHOLD SAVINGS BANK
MAY 14,1974 - - ... - ' .
JUNE 11, 1974 - -
AI/GI/ST '. 6, 1974 i� Mita g* .
`. LAND SURVEYOR -
. '
?LYS.LI NO.USTSS . ,
.:�.;�.-,,. R I VERHEA D, N.Y.
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