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JUDITH T.TERRY d °'• ym Town Hall, 53095 Main Road
TOWN CLERK = P.O. Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS VO Fax(516) 765-1823
MARRIAGE OFFICER �yif'O ao����� Fax
(516) 765-1800
RECORDS MANAGEMENT OFFICER .( �1
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. 3665-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner MUNAFO, JOSEPH AND OTHERS
Mailing Address 1 645 SILVER COLT ROAD
Mailing Address 2
City St Zip CUTCHOGUE NY 11935-0000
Property Address 1 1660 INDIAN NECK LANE
Property Address 2
City St Zip PECONIC NY 11958-0000
Owner Telephone No. 516-734-5921
Tax Map No. section 86.00 block 4 lot 6.001
Cross Street MAIN ORAD
Issue Date: 7/23/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
ar,gr I
OFFICE 'OF THE TOWN CLERK �c,VFF�CA-,--
Town of Southold 0�� , CSG Application No.��
Judith T.® Terry, Town Clerk .� , t ;` .y
Town Hall, 53095 Main Road ) $10.00 - Residential___
P. 0. Box 1179 u' : ,," z $25.00 - Non-Residential
Southold, New York 11971 O`p% Vi.`-; ' .$
Telephone 1in 0
" .t
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE 104 /36
O'1 (-1,N A-PO
OWNER NAME: frLULUeo/JO5OM 40- 2) art-if-PS
OWNER MAILING ADDRESS: j15 ILO Com-[ Rifl--®
CuTC't-OCU'a? /J
V . L cl.
—
OWNER PROPERT.Y-ADDRESS : (ic360 TON(& Nge-1C LI 0!'.
OWNER TELEPHONE NUMBER: —7 v.t-I— o'LI
TAX MAP NO. : Section %,043 Block y Lot ( 0 ,j
CROSS STREET: {4I.YU Rd1 b
TYPE OF SYSTEM: Septic Tank fr New / Existing
Cesspool 1" New i/ Existing,
Residential j/ 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.)
/
. I, ✓.
/ Signature of A+plicant
,
RECEIVED BY: , 3- . ..,
0.1
_
own Clerk's Office
DATE: ? la/./77
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188'
LP WELL N/F loo• BELL .4_.-.‘„--1. LP -
RES DENCE RESIDENCE PONTNO ��� `
PRIVATE WELL PRIVATE WELL
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ai
2 lb
Fed m
SUFFOLK COLMY DEPT. OF EALTH SERVICES
LOT 7 VACANT FOR APPROVAL OF CONSTRUCTION (N.Y
VACANT / O •/- DIN/FARM ROAD >>
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2 : t oo iV c i O h -I AM FAMILIAR WITH TIE STANDARDS FOR APPROVAL MD CONSTRUCTION OF SUDSURFACE
o W <i" y I 1. SEWAGE DISPOSAL SYSTEMS FOR SIAGLE FAMILY RESIDENCES. AND WILL ASIDE or THE
I r' a 4 0 a CONDITIONS SET FORTH THEREIN AND ON THE PERMIT TO CONSTRUCT
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d 5 66°00'00"W \ 25 oN c L J qti' VACANT
is
• AT 250.. . DR IVEWA I EASEMENT-A�PR°NT 1I 1,® 'hoe
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LOT / os shown on map of
N. LOT 2 aA: ANDsu_
co RESIDENCE U/C ;N ((--..-1S7C21;1
� w9 F� WILD OATS"
PRIVATE WELL ra A ( C
BELL c.ruaaou�a.s.rum ,N\..• ' e < * FILED MARCH 9. /993 o s No. 9331
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ru'nus.ummmeor moan LP C (II, 1�1' Y
ana./GM..�V �. p 7, `.na+Ty/-- situate
CERTIFIED TO. �-+ allo, 0 9�^ HAMLET of PECONIC. TOWN of SOUTHOLD.
JOESPH MUNAFOi - OrT - ° ' SUFFOLK COUNTY. NEW YORK
COMMONWEAL TH LAND T I TLE INSURANCE Co.
SURVEYED DECEMBER 26. 1994 BY-
- SUFFOLK COUNTY TAX MAP NUMBER TECHN/CAD LAND SURVEYING
- - - - - --- - -- - - - -
THE EXISTENCE OF WETLANDS. RIGHTS OF WAY AND/OR 1000-086-04-06.1 PAUL W WERLER. L.S. NYS LIE 049875
EASEMENTS. IF ANY NOT SHOWN ARE NOT GUARANTEED POPC
5 DATUM - ASSUMED 126 UNION AVENUE
ZONING - 1E5�1E CENTER MOR ICHfS. NEW YORK 11934
JOB • 94179 (5161 878-2847
LOT AREA - 40000.24 S.F. OR 0 9183 ACRES
REV. J/21/96 - SITE PLAN FAX (516) 874-4164 '