HomeMy WebLinkAboutMeyer JUDITH T. TERRY �.1 �< Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS r� Southold, New York 11971
MARRIAGE OFFICER Fax (516) 765-1823
Telephone (516) 765-1801
y1 aor,
/
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 1799-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New X Existing
Name Of Owner MEYER, JOHN C. AND GAIL M.
Mailing Address 1 2645 REEVE ROAD
Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
Property Address 1 2645 REEVE ROAD
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-3882
Tax Map No. section 100.00 block 1 lot 44.000
Cross Street BAILEY BEACH ROAD
Date Of Last Pump Out 0/00/00
Issue Date: 11/07/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
`r OFFICE OF THE TOWN CLERK ' •� '
S�FFot,��;- 1 9'Y
Town of Southold 0�� _�_:•, _ �G_ Application No.,/
Judith T. Terry, Town Clerk rt t %) $10.00 - Residential
Town Hall, 53095 Main Road a ---g a4 .
P. O. Box 1179 v' --` 1("'_ % 'moi ; $25.00 - Non-Residential
Southold, New York 11971 • O ' iN' •`
Telephone Q( `e•
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ I0.
DATE & • 6, /9 /
OWNER NAME: TokN C T G \ M. ak,(i��
OWNER MAILING ADDRESS: 0/6)1.5 k !U
kat-hick- t)v I J q
OWNER PROPERTY ADDRESS: c LPY5 12Qre.._ Qot _
Nati-wk.k. rI95�
OWNER TELEPHONE NUMBER: (9.92- 5Acl' 2 (AO -5Zo7�)
s TAX MAP NO. : Section / 0-1.7 Block 01 Lot 641
CROSS STREET: rt- p-IL r Batict ae_ax.,L, k_d„_.
TYPE OF SYSTEM: Septic Tank • New l Existing
1 Cesspool New V Existing
c Residential '7 Non-Residential
DATE OF PREVIOUS PUMP-OUT:
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.)
At,
Signature of • ip1 cca'ht
RECEIVED BY:
�� �
Ritt Office
DATE: Nov 071991
!w Clerk SoT$tiord
6 G
C.0%'' `OSE
,DO
1 \ .
i
\\ o.0 \ '.••Po /
O It
N s ,p
\\''g'''
ox
yc' ' ��
\ ,
\O °
\ .041'\'‘'‘N‘Cl. v.- \ \
C` - /
\\ •...15= 0/=,p
\ �oSED \ .
0 \
)
/ i is _
\--1- ...- ,
fro / ISI I VL
. - � 2
\ - cEv Y\tiK i e0 tN / / O ��
•\car` ,� ��� >' .K CP
P
t \ ‘2\'',.1\ts o ,�/ l �0
\ srk......4- ,.,.. c,,-,0.sz. ..... --- o\ c-Dc)
v . '
AN t.
O•. � Hr\ 4V�s \ / /\ t
Ca 1.O �� j
Pce
\ ‘ \
q ' • \ \ J
Ns. .16,\. ,. ./'''
/. C' \\SIC\J'
5.Q;-_ /.,,0--� oy� J��
\\ 1 /
\i0 Gp.0\ tis �' / FQ oP h G � - 7 b
i \X,
O. 0
I
s\a \ .
1 � s�- 20 . \
-- \ C
—5-----
\_•.J\P��, .'1^Di 104
(l i ,.mow! r-:. ` " Is 1, is !...Wrr; 1 II,tel. Rio v +.'•=r- a t-
r:,-Tw../
IL-)7.:c,i . _, i ii •.i ,a =w','.i. t�..t{•. :....11 \ 1 �". It...;':' /'i t�• :'. o"t l'
l
SURVEY FOR
JOHN MEYER a GAIL M. MEYER
LOT NO.670REG0N HEIGHTS.. DATE
)1K COUNTY DEPARTMENT OF tiEAtTH bt VIE.1 AT MATTITUCK
SCALE
+.,,uni nc Cni ITHOI D ,,,,