HomeMy WebLinkAboutNolan (2) L" I
' ' go
•'`- ''i ce
Town Hall, 53095 Main Road
0, P.O. Box 1179
®2 t'�� .�1I Southold, New York 11971
JUDITH T.TERRY _� / 0' FAX(516)765-1823
TOWN CLERK TELEPHONE(516)765-1801
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. 1112-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner NOLAN, JOSEPH E. AND ANNE T.
Mailing Address 1 685 ORCHARD STREET
Mailing Address 2
City St Zip NEW SUFFOLK NY 11956-0000.
Property Address 1 685 ORCHARD STREET
Property Address 2
City St Zip NEW SUFFOLK NY 11956-0000
Owner Telephone No. 516-734-5479
Tax Map No. section 117.00 block 5 lot 38.000
Cross Street 2ND AND 3RD STREET
Date Of Last Pump Out 0/00/00
Issue Date: 5/16/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
-a a.
OFFICE OF THE TOWN CLERK
Town of Southold g';141gt
0 11Q Application No. I 1 I J!
Judith T. Terry, Town Clerk yarr is Residential
Town Hall, 53095 Main Road c sr ��
P. O. Box 1179 Non-Residential
Southold, New York 11971 O 11W'
Telephone Y► ei
(516) 765-1801 '
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE J//377
OWNER NAME: -3:5E(94 E ALciLeE 7 ilerC Mt"
OWNER MAILING ADDRESS:/ / D/Cc //20
i -(1 `('z5GGA "AY a2,5---K
OWNER PROPERTY ADDRESS: f gb O ,'CG;6 [J $7
/1P7-61‘:/ �66.-- 7 ay /GPS
OWNER TELEPHONE NUMBER: cS /b— 73 Y 6 2,2
TAX MAP NO. : Section /(7- Block eg- Lot
CROSS STREET: 0,4 D� � -471./ce,/ oC 3 V-S�P�r
TYPE OF SYSTEM: Septic Tank r/ New Existing
Cesspool I! New Existing I7-
• Residential V Non-Residential
DATE OF PREVIOUS PUMP-OUT:
LOCATION MAP: Must be attached hereto before ermit may be issued.
(Locate building and system; give north arrow and feet
of distance, approximately, to building and closest road.)
lt�
/ Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
- H,- H. rut Atli/ ' 1 v ,
I 5.83`49'/0"E. 77.00 -
•- --- "__ 4_--- -2x-t - --- -;_� --x ,.fes frC9t ;^v1 h o Prober-h../
�- aft,; i. 4 Suf"I�eCI;? ' �'O1'
i o f r. ham., 1 to r';v4J 1 i /1 '''•C eP ti/ j Nolan
. 4 .Z-4 1-717 e T.
' �: '-, , T'.,, ;:-ir; Sou hold, N. Y.
w+ �' ZT ! I
4 ,,
{ 1
fi 6� i UNAUTHORIZED ALTERATION OR ADDITION i
T!) TO THIS'SURVEY IS A VIOLATION OF {
f•; 5 SECTION IZ209 OF THE NEW YORK STATE ,
` t ^ I --- EDUCATION LAW. CC r 'n _ / • 1
I
) .� ! , COPIES OFl THIS SURVEY MAP NOT BEARINGy- O -��V a
� THE LAND1.SURVEYOR'S IN:CD SEAL OR •
I
_S i EMBOSSED STEAL SHALL NOT 6E CONSIDERED '
{J
ILO
TO BE A LID TRUE COPY. l
I NI"� 'L J,r• ha• f lr) GUARANTE ,INDICATED HEREON SHALL RUN (] - 140 f7 u me n t
ONLY TC TJ-( PERSON FOR WHOM THE SURVEY
i ‘U -.r IS PREFAUL:,(A,.D ON HIS BEHALF TO THE
I TITLE COMPANY, GOVERNMENTAL AGENCY AND
_ LENDING INSiiTUTION LISTED HEREON, AND
k-'C N TO THE ASSIIGNEES OF THE LENDING INSTI;
1 _ TUTIOK (,...A.,ANSELS A.^.E NOT TRANSFERABLE
TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT +
1 1 OWNERS.
I -- !I- >s - x _r-- - f _I, ' _ -- s s- • - ;a
N. 83649' i "sem, 700 3!i.63 1 i
;n5clr'anLe Corn katici crld "a , 1
'r) Socithord Savrf75 Bank 4#
o 0l�'C11Cl�d (_57-reel" as Sury u. ed ,+ila.-. 6, 197.s
In ,1 ZO E'rrCk. ' 'M-i��,ti1 P. C.
Z` {is t �rl ��-+ 1
g __- �---� --_. . _, ----- -- ----- + d
0.d GPeASe- VP 3