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Home My WebLink AboutNahas Os S%� m „ y JUDITH T.TERRY � � °""" � • Town Hall 53095 Main Road rte. TOWN CLERK fzw t P.O.Box 1179 elti;Nti , 9 � Southold,New York 11971 REGISTRAR OF VITAL STATISTICS F 4 � �1 Fax(516)765-1823 RECORDS MANAGEMENT OFFICER MARRIAGE OFFICER =_ ®l 0 •,®••I Telephone(516)765-1800 FREEDOM OF INFORMATION OFFICER .01g° OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 3316-R Residential X Non-Residential Fee $ 10.00 New X Existing Name Of Owner NAHAS, PAUL AND BARBARA Mailing Address 1 BOX 1249 Mailing Address 2 City St Zip CUTCHOGUE NY 11935-0000 Property Address 1 3005 WELLS ROAD Property Address 2 City St Zip PECONIC NY 11958-0000 Owner Telephone No. 516-765-4009 Tax Map No. section 86.00 block 2 lot 4.000 Cross Street MAIN ROAD Issue Date: 3/27/95 Judith T. Terry Southold Town Clerk (TOWN SEAL) • `OFFICE OF THE TOWN fCLERK ' Town of Southold �S��FO(,�� , X CD Application No. �� Judith T. Terry, Town Clerk` 4 ' ''.:,:x., .•c $10.00 - Residential Town Hall, 53095 Main Road ��,.�, . • p. O , Box 1179 �: fi f ' h�i Southold;'New York 11971 ® '41.4I,%- -*$ $25.00 - Non-Residential Telephone • Ol ��O �� (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. i1 i3 iL Fee $ / 2• dd DATE aq fistrth ' ggs 'OWNER NAME: PO 0I, and- 6a`1 ra-- Nahas • • OWNER MAILING ADDRESS: b/- 1 aY 9 &lTchdc/ue, N. y /7 ‘,.3-1--- - OWNER PROPERTY ADDRESS: 300 ,5- tui'//�/5 d- . 79e c1 l cL, `vl 7 //7575 OWNER TELEPHONE NUMBER: .96,j - q(o q y TAX MAP NO. : Section 8( . 00 Block Lot 000 CROSS STREET: Hai n /266 TYPE OF SYSTEM: Septic Tank New Existing Cesspool New l..,---- Existing Residential 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.) Signature-o plican RECEIVED BY: . n lerk's Office DATE: 37. 7 ?_)--- et- -- -- : A SUFFOLK CO. HEALTH DEPT.APPROVAL H.S , • I . 210-94-007G NO tzti...... 1,1 ..1 . i ‘.... STATEMENT OF INTENT I THE WATER SUPPLY AND SEWAGE DISPOSA I ,. - • wefir . (;oo1:11- 2 , ..si . SYSTEMS FOR TWA' RESIDENCE WI L --:! L 1 CONFORM TO THE STANDARDS OF TH / A ;1v7,4).,c' c,-•: 7-i-- - /C7ROP --,--;? SUFFOLK CO DEPT. OF HEALTH SERVICE ACTI- ti . „ '.1• _ 56 53 LE-. - 00.50.t-. .-74.44"V.,47: 1,-'-h (S) -,-., :- , APPLICANT . ___---7,‘ , . . ..; . _ r--.‘ /--..---)i A) . 1 _-.- .— SUFFOLK COUNTY DEPT.!- 00. HEAL i -.1 ' ,.- ---lb• , ... , i''''d • l• Qf ',I - - st 1, , /417- - S,ER VICES — F.O'R •.ApPROV.AL ,.. if " S'ii:fN GAR 6 { VP -.? - -e 01 ' • ' - = - ...-1 , c- P---c o N i 6,N)! .-DATE; - •- „. - • •. _ ir) -.. S , .ti.S:REP.WO, 1,-4-w--tg-r- • •-• \ , ' c-2 7 gDoc k. \ r t ',•••:4-. ‘c. ,. t \:•_;,.. 1-", %,' N•• '4' -, i i..i... ‘ - •Itssi• N: "k - SUFPOUS CO:TAk MAP DESipNAT*314:- .. . „ . hole DIST. SECT. -BLOCK - , .-PC1,1 - _ - - -a• T ,_ ,o. r A I ...-, \r 1900 bees - . --o. •s '• .!:4--'' ,11,,.i. -,. . eE4-f•• 5'4'z...-57f.);_:.:,W. „ZZ7./0 - OWNERS ADDRESS: _ ,- = •,) - 4.-, • p„,,;: ,. ... ... i. • 11 ," ,...„...,,..• • - -,....,,,,,,. / I...-. .,, -7 r-.: , --,-4-, • aft?db,,,42,,:7-fi, ?..f?%•-_,..,..11,00:',: .0., . I v ( , . ,. °-, 1 ; -7 . • ..- . . , .. . . , „. - .-•. 7-04, ,444-.44A9: - ' -., .7.-- -- _ . 1 "'ell, ' ...-,%• • i o•A. C_,ID 6/1'I-17.1 1/2 1 ------.1 ' DEED-.,4.56'16 ,' .P.,,2 f 3 ..0.4.h.'•..' 1::3..1:f.' I . i i K/G.4 .4 ) •.-. et:-I/0 V7 i_9((-,, /_ '/Dc-k , 4., ;...,,,, TEST 17,10).:E --,. '-,_ ,.VA „••..,-.;,-.... ____:.!...,_.____:.4 r , Section 7208 of the m or: . 'coUna:odrtnyitraIto7;:i::„...,:::. .., , to this survey Is a violation of,'• '',-• '3 51Att A?mi:'5 tn To -:. ' Eckca IS°n 7se.) ft/e a if , 5 6 O' 14:i:11-'6:I .V e; V'0 ; , I ,--- ' ' 1 ..."..-- Ct2 '(_- -:::----' - ; Airtelieci Qs-I-. 20, 1994 . erkta --7 • (F.) --, i r 6 0 ja 1,C; C.: „ FEB. Z2,1995 I. .,11;54.t.e-fl:lifi.77.2;11 ''..--- ‘..1.,:;t3trtie:::,,preb:ab°ss:pany.rardtpared.oa trodeesesth:1,71:19:5haUmeoffir.hee'beitr:shalgency::,41.rry-rum:en:ii..d -____ ___,, .....L.7;... -.. tending Instkution listed her6n,aircl • - - , to the assignee,of the leed,ng hitt- -4.0.44.4-4 .7,, -` tution:GuaranteOzir,e not transferable , - Mar. 27,1995- __,67• -. , •,. to adcrshonal ir,41,[1,0:?rsutiqectu ent. A = /r K-o./ o.:. - , . Ard, -, ,,_...; _cmiltrs- -•,f;._'.--,F--''',', ' i-: 7 Aried: Z.3,;'.518 s../. (to 7iie lite) . - -:-. . ..:fr'eoesit#: -- ",- .` .-:- •---SE40:::::', -,-• -..--_ 6 uar-a/7-teed to (..--arruriciak)colth - ..7-- -,,,rr - '--,----•le' - --' ' 0 -...1'.`i ., .' --yr, Aga-Ale - --, ,o<<, --,...,4_, .. Land vitle I t fk54/rye;le: 7 '1,.). r: --,: ' -.'•'' leiS-•(c?' . ' ,,),%3:- • ' • • .• 2- '-‘ _'-'.E•• V° , Eo ',, S. 1 ,rveyed drily -Z41994. . ..:-_-, _ •,, ,.; ,., ..,1, Er:,l' i. _7.:., !,c, i . ,. RODERiCK VAN TUY(t.P.C. -- .. , ,`..-'-`-',.. .., ,., ''`.c• ,---1'••••"5------.,,- '<4;r:-.. - /0. If..........- ..........e -. .:cz. --0 4 ••.i, r'... •^.•••••••f°LAND 6°, ”. LICENSED LAND St1'RVEYORS •' - itfr-t' -•rf•••••• •,, ._. __ __ 'r - -:' - • -''' :.': .',...1r---'• , ' .r4. ;.; ;'