HomeMy WebLinkAboutNelson .y J
C .
tr4-41A`N ', Town Hall, 53095 Main Road
to it P.O. Box 1179
� �2s ��•�i� Southold, New York 11971
JUDITH T.TERRY tr/ ���1/ TELEPHONE)18
5 6)765-1801
TOWN CLERK
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 1253-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner NELSON, EDWARD P. & RITA M.
Mailing Address 1 225 CRITTENS LANE
Mailing Address 2
City St Zip SOUTHOLD NY 11971-0000
Property Address 1 225 CRITTENS LANE
Property Address 2
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 516-765-5532
Tax Map No. section 70.00 block 11 lot 7.000
Cross Street BEACHWOOD AND PARKWAY
Date Of Last Pump Out 0/00/00
Issue Date: 9/26/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK •0
Town of Southold S��F�`� 'I
CQ ' Application No. 7oZS3
Terry, Town Clerk 0 =, -
Judith T.
Town Hall, 53095 Main Road 8 < 't;; ,c $10.00 Residential
P. O. Box 1179 cn ve p i
0 ';*%" .` $25.00 - Non-Residential
Southold, New York 11971
Telephone 4Q( ''�0���
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE Cl," 2- 1
OWNER NAME: 67;'WE1-r P /\-16-z-•so y•
OWNER MAILING ADDRESS: eDS c.(Z-!T'NS L/-7v-L•
oU Tr/
OWNER PROPERTY ADDRESS:
OWNER TELEPHONE NUMBER: 576_ 7( ,--._.. €S°G—v�,
/600 -- 70— F- l 7
TAX MAP NO. : Section Block Lot
CROSS STREET: r3 f/rt* w Ø -co rb tp rfr-rt.. CA0A-ki
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: — el
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.)
Pf 1
Signature of Applicant
RECEIVED BY:
Clerk' Of"iced
DATE: SEP 26l989
•
.f'• •' , -• - y� • ' • • - , t ,..1,.'1- , ji r,t `;`�
yrs • •- 'Sc , '`.
•
•
te • • ,
� : • : '; ,✓ r �i 1 r ' ; Tti L-
• • GAI`.
:U L....=....... ID /, - , " , . ...,
1L }
•1: _ • > ' m`zt'_'--,..,d—,R�';= �. •_ 1^---"tom +.r.. . .. ( t'T 1 ,. .
•
, •l l2 . R i 1
ri
;r• 4y. ,'_ .R. I •. .fir ,.rt,,_.• .,.`
R • .• ' ' t . ' - ,' ' `} ' • 1/ ` • , R •^is�+SS.0�,'' •,.''1 •
"1 u
. ' 'QI/,u,�SYtRlta)•Aaf41CR
. m (O f4tIS 4U YEY ISIA VI
i • '�FCTIUN 7289 L7F THE N
{/�).�y • ` • '+••• •1 tr' IIDIR:ATION LAW.: --••4
1\10t6.443-.i.
1 •
` yl ���yy••�GG �j h 'w t�` ��y �• {_ry GOflfS.OF.THIS SURVEY
RT'.. D .WOKS,• :8r-el .:IQ'M `OF 5Q[,/ 14, N'O Z)V: F- [LL.D. ilNi • • L4E LAh6 6UVYOR'S I!
' { ( (�. -�y rr �+� rT y��- �!
., �__�}�{ �._ -.,._ _„_� • • L150S5ED SEUL SFIALL 4
.: :Fi- :S F'° Ca, (l.:t;,,l2K4.°'S,.ct,1,Fis['G:C-••A ir•. MA'`Y . `1`•,1,a?„1,4..i.,' •. i J '${2 6E A VALID TRUf�co;
SJ. • ti1F 5 C;SATED,''2"551FFF.., C.. k ..INIA17. . 11A •&r.tI. :-:fAJ...,11 .'�•• -- „ , . , `r :pito,•TO THEPc;;ON'FC
' e . •n''..'•• • .� - .r; , `•fid iP,.FPA9t'�i,AND GM'H i
' ` ., • - `' , -r,[r5LE CO. ANY;10VERI:
.,, .. • •.,,. .�.• TITUTI-
�' . • L! LQ Tt$fr. QN?E5 OF Ti
•J _ ' , 191.J0L MAN Z.I M
R :L;', r • ' ,'S:•RJ 14DIT OVAa. INsimr.
''-7 �y14 -1 . •�,` .. ` •.,,�i,- ',� :,: '• r' 'i•:• , : r; !
f".T • C'-' •r%, •,. 4 1'•.e,, `: 4. a
rsr 1 �.,.Z..
' .. ' .• ., . ,.. •;‘,. C',f•. f 4 v _ ";• ..i4: P T;•+4t.•i *fir-a,?y,