HomeMy WebLinkAboutMilliken JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK ® P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Hcg Southold, New York 11971
MARRIAGE OFFICER
V. C) y Fax (516) 765-1823
r"1/46% V/ 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. 3060-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner MILLIKEN, JOSEPH P.
Mailing Address 1 214 VOILET AVENUE
Mailing Address 2
City St Zip FLORAL PARK NY 11001-0000
Property Address 1 16265 NEW SUFFOLK AVENUE
Property Address 2
City St Zip NEW SUFFOLK NY 11956-0000
Owner Telephone No. 516-734-7813
Tax Map No. section 117.00 block 6 lot 26.003
Cross Street NEW SUFFOLK ROAD
Date Of Last Pump Out 10/00/92
Issue Date: 7/13/93 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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III
OFFICE OF THE TOWN CLERK ec3IFO(.,(- -
Town of Southold0-� � `` e4-% Application No. 30
Judith T. Terry, Town Clerk 4 } $10.00 - Residential
Town Hall, 53095 Main Road
P. O. Box 1179 c .` $25.00 - Non-Residential
Southold, New York 11971O�AO .TT0���`
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Telephone j
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3 Co
Fee $ /b op
DATE 7- /02 -
OWNER NAME: Jocepli ai3Ore),i
OWNER MAILING ADDRESS:
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OWNER PROPERTY ADDRESS: P 4) Si) -rail< Ave
Nero& Sulecolic , J/9-5-b
OWNER TELEPHONE NUMBER: 344 - 79/3
TAX MAP NO. : Section / ` 7 Block 013 Lot a(. _
ACROSS-STREET: -e.;,J \ 7k R,,.
TYPE OF SYSTEM: :"':Septic-'Ta'nk_" New Existing
Cesspool New Existing ;g/
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: A pre)X . O1'-odea- I q9-:17
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.)
.1-1/ P
ignature of Applicant
RECEIVED
RECEIVED BY:JUL-12 1993 _
• Townr:Clerk=s office . .,
' Southold Town Clerk
DATE: . - -
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THE OFFSETS (OR DIMENSIONS) GUARANTEES INDICATED HEREON
SHOWN HEREON FROM THE SHALL RUN ONLY TO THE PERSON JOB NO. B/—S.S-¢ FILE NO. /S - -a- 6_�
STRUCTURES TO THE PROPERTY FOR WHOM THE SURVEY IS PRE- ;
LINES ARE FOR A SPECIrIC PUR- PARED, AND ON HIS BEHALF TO PROPERTY OF
POSE AND USE AND THEREFORE THE TITLE COMPANY, GOVERNMEN-
ARE NOT INTENDED TO GUIDE THE TAL AGENCY AND LENDING INSTI-
ERECTION OF FENCES, RETAINING TUTION LISTED HEREON, AND TO
WALLS, POOLS, PATIOS, PLANTING THE ASSIGNEES OF THE LENDING
AREAS, ADDITION TO BUILDINGS INSTITUTION. GUARANTEES ARE
OR ANY OTHER CONSTRUCTION. NOT TRANSFERABLE TO ADDITIONAL
UNAUTHORIZED ALTERATION OR OWN RSTIONS OR SUBSEQUENT SITUATE AT -. O1JT��OL
ADDITION TO THIS SURVEY IS A
VIOLATION OF SECTION 7209 OF COPIES OF THIS SURVEY MAP NOT SUFFOLK COUNTY, N. Y.
THE NEW YORK STATE EDUCATION BEARING THE LAND SURVEYOR'S
LAW. INKED SEAL OR EMBOSSED SEAL SCALE � •- - 3 0 • /- 6 - '9B
SHAL $ • FONSIDERED TO BE• DATE
l ItOR$ • FILED MAP NO. DATE FILED
GUARANTEED ONLY TO: c ' Y
F/•esr ,.4.7/77.E.,. .. 4�+ L`i .1. y BOOK & PAGE z37 - �� 117-3
7.--.,".-.e....".-.e....• -• .//o• ///- - `•'z�,n.% (0,, j CONSTRUCTION DATES
To
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"tom a/r., /77o t. /nyibJrX t-y ;i HAWKINS, WEBB. JAEGER, ASSOCIATES, P.C.
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SURVEYING & ENGINEERING
h't - - PORT JEFFERSON, N. Y. I BRIDGEHAMPTON, N Y.
WILLIAM L. JAEGER II Y. .. L \6 E94i� a9 473.0468 I 337.3873 •
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