HomeMy WebLinkAboutOlsen 1"-
4110701100
"41107# QL"T•
Town Hall, 53095 Main Road
� y ��� P.O. Box 1179
® Southold, New York 11971
JUDITH T.TERRY 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. 1029-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner OLSEN, ANNE H.
Mailing Address 1 660 OAKWOOD DRIVE
Mailing Address 2
City St Zip SOUTHOLD NY 11971-0000
Property Address 1 660 OAKWOOD DRIVE
Property Address 2
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 516-765-1596
Tax Map No. section 70.00 block 12 lot 26.001
Cross Street CHRISTOPHER STREET
Date Of Last Pump Out 0/00/00
Issue Date: 2/22/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF'THE TOWN CLERK = _
Town of Southold �®� CQ ' , Application No./0` '7
Judith T. Terry, Town Clerk y
Town Hall, 53095 Main Road Residential
P. O. Box 1179 cn =� '° i ;' Non-Residential
Southold, New York 11971 O ® ' F
Telephone ain 0�o
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
FED 151 . for
8.
o°'` OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE 'z=.2/9/.,
OWNER NAME: G�2�/�
OWNER MAILING ADDRESS: cA__>
OWNER PROPERTY ADDRESS:
OWNER TELEPHONE NUMBER: 7J�/-S7S
TAX MAP NO. : Section Block ' Lot ��-
CROSS STREET:
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT:
t
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 of Applicant
RECEIVED BY: e_ „it
,c„( r CIe'' 's Offic:!
DATE: FEE l'=q
1 I
,
1
,
I
'
i
N
CNI .!STGPHER. ZTPEET
11
N. 83705'30"E. ~- 1-1-0.00
3 --- MAP OF PPCF TY
o >
• --N,51. TO f' 2,.....r.....: 4 j 7 SURVEYED FOR
1 ° f A.N NE H. OLS S E N
t r/Y i - i� 3_ i r
._i� z- __= 1 ST'Y. �!!! AT
� UT 1-101-D
nr.) d ! '', t r-—ia
1 3?,-AG� $ , r- 40• ;.z L.�' =FOLI{ CO. , N. Y. 1
, ,) ID PRE.EZEWAY , '4'
,
'7) s'D I ' ' ek? c 0 i !
:NT ZI 9 0 -
hi ® — ' 10 0 I
1 40.00 ur 5 Jr� �%J':�0 „Vd. -- SCALE : 9G' - 1"
1 _ Y
il
-� Q
0 !o = N1 Ci i4 U t�i S� t
, B '
v -SUFFOLK. Coos-:TY TAX PAtz..CEL:(OCO--010-IZ-Z6.1
MA1\1N
crs
Ns) 0
UP.R.At-TEEr5 To - r?1-4E2.1CAt+1 - -
`O O Unauthorized alteration or addition TIT L F IN S U R A c'C l" CC. AND r o 1'H E C'J T t-i C)L t
—' r to this survey is a violation of
Section 7203 of the New York State JAY,NGS !SAL-4k A E 61.1 r;V E Y;=G sal A t<• 13; 196E;
Education law. F'
Copies of this survey map not bearing
the rand surveyor's Inked seal or Q �'' Vila TO E.b P. C.
embossed seal shall not be postdated t'''�� — to be a valid true copy. ��
- Guarantees indicates hereon shall run ----------- =—,
only to the person for whom the survey -
is prepared,and on his behalf to the L I` r A! E G LA tr o St; 'v E,,•U
title company,governmental agency and -
lending institution listed hereon and G g E E N P G P2-i-, N. Y.
to the assignees of the lending Insti-
tution.Guarantees are not transferable
to additional institutions or subsequent