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HomeMy WebLinkAboutMosblech ;ELIZABETH A.NEVILLE ��� ®�y '0, Town Hall, 53095 Main Road TOWN CLERK • ® P.O. Box 1179 Southold, New York 11971 REGISTRAR OF VITAL STATISTICS Vr2 'I� Fax(516) 765-1823 MARRIAGE OFFICER :1/4444 �1 RECORDS MANAGEMENT OFFICER � �® 'pa® �i Telephone(516) 765-1800 FREEDOM OF INFORMATION OFFICER 071 ' 1... . OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 3764-R Residential X Non-Residential Fee $ 10.00 New Existing X Name Of Owner MOSBLECH, EDWARD B. Mailing Address 1 755 BRIGANTINE DRIVE Mailing Address 2 City St Zip SOUTHOLD NY 11971-0000 Property Address 1 755 BRIGANTINE DRIVE Property Address 2 City St Zip SOUTHOLD NY 11971-0000 Owner Telephone No. 516-765-4356 Tax Map No. section 79.00 block 4 lot 49.000 Cross Street ANCHOR LANE Issue Date: 2/13/98 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) S 10 I,, OFFICE OF THE TOWN CLERK %c31FULA' Application No. ,6 TtjWN OF SOUTHOLD lj ELIZABETH A.NEVILLE,TOWN CLERK ' r 't, Pry s s: .G $10.00 - Residential P.O.BOX 1179 �" �� $25.00 - Non-Residential SOUTHOLD,NEW YORK 11971 � . ' . [�` •*'$ Telephone _OI 4 Y►b, .� (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ /b . DATE e9?" OWNER NAME: bt 14 . ,MDS &I,ECd4 OWNER MAILING ADDRESS: ( &All) ( I iV 5Ec ir(k0 i y ( 0-1 ( OWNER PROPERTY ADDRESS: 'Y1-'2_ OWNER TELEPHONE NUMBER: S —� TAX MAP NO. : Section Block Lot CROSS STREET: /K)I✓ (Z_ L � 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.) eq-411147( /44-4-t— /1,u- 'Lem Signature of Applicant RECEIVED BY: Town Clerk's Office DATE: . . . I. . , . . , — / A A / Y.', _.... _ . - n , -- •Z-.4 C.-'7'-r. / V L•//i."•;1"....i'" .....-7,CI• - - i . . - , _ . - . i ' (‘V n • .. ., • ato ..z, o Zaa Ai - i ..'". n,..C.;• ,...-2, 10 • . 1/4z . . , ., • - ,., . • , 1 * - . -• ". .... , . 1 GE; --.. --00 lal , (.3 ...;,.., i ..r, -- i . 1 4 -4(0/— • ,•21( -j6r -• `'.i " " (-• . , . . 1/4. < , • I.2 4- i . . , 1 •• - ! 0 .2 , '.r. ,> 7 _ . . \... '.I . eidom ifiteja.j.e. : -N .7—I•f% r--/-/ ),-"--Z . „ __________________7______1 • q....., . 1,0\ ./..„, 6 - C.,.....--,A./0, (..i.,./: -, , _, ---:..r... ,-. , ..-•:-, , " , . it \ . . ., ......1., ‘ . I 1 . . ,_ . - - . ^4- `.1 i . -. - ,_-‘:!-•' -Ati.,/PY-1 el., -.. ,--- ..1-7:5 7 . . • ig . . , -•••• i - ....... . . - • In - ' W.. Reb ( Aki(11 tj M 0 5 i . _ . - . , 1 D) tri . /16//A , ' . . ":--- - . . - . ') -?....7.j,' . . :-_-,4-i,.!..,,...,... ,---.2-,----,------4 .tif,------, ----,--,,,,,•- ---.....—....- 'z4•'''''."-.777:-: ',- .7.:-f..c. ,:-,fr..:.,_...----c_17,-..-.17, ::-,..- -;',7.-77-z--•,,r,_:,.,,,,,,-.7--.77,-_---=• r-.. . . , . . . . „ . . , • .. , . ' . 7 _ _ . • . - . , , re.-3 -- . 2.-- , . a - . I \\r---1./ /c..-_-_ .,,,-.'v . . . ' . . . :21 '--. / r 4-.)1.- , p • 1,--,-.• c ,, , . • 7- .•.-;iz-- .):,77--/ if.-:),LL.,-,1, ./1. '7;./ . . .. - ,‘,..7 . . A =- ."--_,.le.---,/,-..- (-_-.: .. . ....--- / . TV./,,,7.*/)r 'r- .S - s.-- /-*7-%.72 •';-3 - C:-.---11-4•7,/. 17-r.iI e - ..- 7/0 -./i,.c' ,,e-k-3 i,-;,:- _-',, - : - 4,), , , •:- ''. - ' - : • , , .. „ / • . ( ,i• , c(i. ;i:, 77 71/2-( ' /,-' • -..-:-.:i,-.•.1 ,--..* (:. r,r1-.,,:.•-..."1. , x -2.,.":- r 1--_ i ; - -117(-- ,::-..,:.....---/1",•.:-., fol N . _:-I't f /.;e1.': L.?/.7,-.7 ;-••• : -• •- L.-. •,/1./.-•:' '1'---I Z(27' /2/-i,-)'./,'e- a":*7.. :7 17 0:-/..yl Y e."7.-/'e••• i''(:.; ''' /-•' . , — -,...., j i q „ A--/::-/6/ /6 ,-',27).6 7 /--,-/---,7-.6.-., .--, z ,- <? -/._, --- 73:e.-c-1/(2,.i , ' . .„ I.4- o / , ; -/i;(,.• ,,:;.,,, -/-7--- i,E. C.(--'e'l=7,,/,I \.,4;2 P! if -fj.. : -'? , ,-.7->•-_, r . • - ..".. - - • _4, .--7 .,-" —• Li..,,j,"7::,/ 'IV ,.,%:•"1-1.__ 'g'-'41.7 - .-/e. C 4.: .... 17;-I-1",..-•,.- ,•;., '''. -•'_;.:* /./r..;. •`-t- ..-.7' :.:-.-‘ ••"' .,,,,.--- -- L. , .( € -,- r). ... ........m....... ..-. .....--...........r....-...-,