HomeMy WebLinkAboutNiecko OFFICE OF THE TOWN CLERK 097/./(C,O
Town of Southold 41x lj
Judith T. Terry, Town Clerk •% _ ' �
Town Hall, 53095 Main Road
P. 0. Box 1179 to V:4, Err y� •
Southold, New York 11971 - �O�- ••
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Telephone
(516) 765-1801
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
- SEPTIC TANK or CESSPOOL
Operation Permit No. 479 , Residential x
Fee $ 10.00 Non-Residential
Septic Cesspool X
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NAME OF OWNER: • Bernard F. and Dolores Niecko
OWNER MAILING ADDRESS: 1505 Delmar Drive
' Laurel, New York 11948
' OWNER PROPERTY ADDRESS: 1505 Delmar Drive
Laurel, New York 11948
OWNER TELEPHONE NUMBER: 516-29'8-5019
' '' TAX MAP NO. : Section 127 Block 4 Lot 10
CROSS STREET: Joseph Street
;, TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: None
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Judith T. grry
Southold Town Clerk
DATE: November 9, 1987
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(TOWN SEAL)
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OFFICE OF THE TOWN CLERK CO HU( ��
Town of Southold �� CQ '; Application No.
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road ' -� Residential
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P. O. Box 1179 cn � 1 � ► �` Non-Residential
Southold, New York 11971 O t�v,V *'S
Telephone
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(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
, for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 2-1
Fee, $ i I •
•
DATE
OWNER NAME: ea,o v'\ F. cwV& bok ti IV i 60
OWNER MAILING ADDRESS: IS-05- err-- �RIoc
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OWNER PROPERTY ADDRESS: Cl-m e.
OWNER TELEPHONE NUMBER: ,R -6 D ( 9
TAX MAP NO. : Section /02 7 Block Lot ID
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CROSS STREET: To,$ {1
TYPE OF SYSTEM: Septic Tank - New Existing
Cesspool New Existing
Residential ✓ Non-Residential
DATE OF PREVIOUS PUMP-OUT: nor“-
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.)
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"j` Signature of Applicant
RECEIVED BIa ''own ALA,
,�fice
DATE: NOV 0 91987
Town Clerk Southold
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• TREET .
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NOTE: - --" 1
■= MONUMENT REVISIONS YOUNG & YOUNG
SUM/VISION MAPF/LED MAY 9, 1972 400 OSTRANDER AVENUE; RIVERHEAD„ NEW .YORK - --
/N THE OFF/CE OF THE CLERK JUNE 16,1972 . .
OF SUFFOLK ONJUNE 22,/970 JULY 13 1972 GOLDEN W. YOUNG HOWARD W.YOUNG
ASMAPNO.5486. AUG.14 1972 PROFESSIONAL ENGINEER AND LAND SURVEYOR
Y LAND SURVEYOR, N.Y.S. LIC. N0, 12845 N,Y.S. L1C. NO. 49893
1F'AUTHORIZED ALTf"&TION OR ADDITION AUG.22,1972
C P'15 SURVEY IS A vl"IATION OF SURVEY FOR: '
ECTI- 72C9 OF THE NEW YORK STATE ,
CUCATIuN LA,/ BERNARD F NIECKO & DOLORES NIECKO • - -oF NC-
LOT NO.I I, LAUREL COUNTRY ESTATE!: s r'
^c THIS SUkv:Y MAP NOT BEARING 0 !° (PSE
-"YOB'S INh.D :,AL OR
O
S L ;EI NOT BE CONSIDERED `P`�D w 41, 414L.
. BE A VA.i,. I•UE COPY. Q OG
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.UARANTEES INDICATCD IIER'ON SHALL RUN' /
);LY TO THE PERSON FOR WrE.M THE SURVEY AT LAUREL GUARANT S'°TO: 17 u1"4". 0
• ID, A'D ON HIS BEHALF 1... (HE
RIVERHEA+ S.i.; INGS .a �.
1 •i')VERNMENTAL AGENCY AND TOWN OF SECURITY') IT.E6 .,W.•'- YCO.
•,, ,.,,.,• ISTEDHLREON, AND SOUTHOLD - 4•
i i,. A fS OF I„I LENDING INSTI- ..• ,V, J191
7,: , A ANTLES ARE NOT TRANSFERACLE BY � �
amu,u...•.d INSTITUTIONS OA SUBSEQUENT SUFFOLK CO., N.Y. /i'”/f ,. ~r,i ,
1. /' (,
SCALE: n I DATE: NO.= 40.— - M 1_2,1922 - - 7Z.--_ �.