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JUDITH T.TERRY Town Hall,53095 Main Road
TOWN CLERK c� ,';;.; g P.O.Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS � 0 " ,�1 Fax(516)765-1823
MARRIAGE OFFICER _ ® � Telephone(516)765-1800
RECORDS MANAGEMENT OFFICER � ED t,„1.'
FREEDOM OF INFORMATION OFFICER -•�•,�,,,�•��
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3366-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner WALKER, PETER
Mailing Address 1 P. O. BOX 548
Mailing Address 2
City St Zip CUTCHOGUE NY 11935-0000
Property Address 1 375 PINE TREE COURT
• Property Address 2
City St Zip CUTCHOGUE NY 11935-0000
Owner Telephone No. 516-734-7201
Tax Map No. section 98.00 block 1 lot 7.017
Cross Street SKUNK LANE (BAY AVE.)
Issue Date: 7/28/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK ,, \VFR �.
Town of Southold �� �C' - /
Judith T. Terry, Town Clerk ���� �� Application No. ��(o
Town Hall, 5,3095 Main Road ,r4 $10.00 - Residential
P. O. Box 11791 ; $25.00 - Non-Residential
Southold, New York 11971 O *-1`,
Telephone,( i
(516) 765-1801
TOWN OF SOUTHOLD
•
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION '.
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 33 4
Fee $ /63
DATE � a, �
OWNER NAME: ca\zt.2p
OWNER MAILING ADDRESS: �c) LA-c CLAr (,L.e
OWNER PROPERTY ADDRESS: 3-11
OWNER TELEPHONE NUMBER:?3 - 7 Z 1
TAX MAP NO. : Section � , O Q. Block ` Lot = Cl
CROSS STREET: \\1\� �v�� V r-)ct v\
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool L New v Existing
Residential V Non-Residential
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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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RECEIVED BY: SI,
To ..t .• : 0s Office
DATE:
JUL 131995
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s1oNS IYOU NG & YOUNG
—S63°54 W. 400 OSTRA UE, RIVERHEAD, NEW-YORK--
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EW YORK
P/NE TREE ROAD � ,�{ JULY 12,199a
�f{g►'�11.� VtY1 AQ�i ALD EN W.YOUNG HOWARD W.Y=
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{E.rr'•� ����Ag •� LAND SURVEYOR
_ HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCTEXPMESItigg �/� I PROFESSIONAL ENGINEER AND H.Y.B.LIC.NO.
- LAND SURVEYOR.N.Y-S.LIC.NO.12845
•
#NEAREST WATER MAIN_MI �'it SOURCE OF WATER PRIVATE�PUOLK:_ ' I
s SUFF CO TAX HAP DIST i2 SECTION °9B BLOCK O� LOT 7•�7 I SURVEY FOR:
OMERE ARE NO DWELLINGS WITHIN IOD FEET OF THIS PROPERTY L SURER K'ALICER & EILEEN lfYALKER
OTHER TNAN THOSE SHOWN HEREON. UNAUT110HIZ(0 ALTCRATIOH OR ADCIITION TO
*THE WATER SUPPLYAND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE TN19 SURVEY IS A VIOLATION OF SECTION
WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT ��y KW SERVICES 72209 Of THC NCR YORK STATE EDUCATION
-
OF HEALTH SERVICES. SUFFOLK COUNTY �AR'1M 4T -
♦ APPLICANT �•1)
. CMIEB Of THIS SURVEY YAP NOT REARING
I THE LAND SURVEYOR'S INKED SEAL OR
ADDRESS FOR AP140VAL Of CONSTRUCTION ONLY EMBOSSED SEAL SHALL NOT DC CONSIDERED GUARANTEED TO:
e� .Iyh l� TO BE A VALID TRUE COPY AT PETER WALKER a EILEEN W/
TEL. 03'.1994 /0-41 oO7?- CUTCHOGUE CEHTERBANK MORTGAGE COI
WY GUARANTEES INDICATED MERLON SHALL RUN - COMMONWEALTH LAND TITLE II
KS RAF 1, TOWN OF
DATE oNLr�o THE PCRSON FOR wNOM TN[ SOUTHOLD COMPANY
■1=MONUMENT 0=PIPE •(2)B NUMBERED LATH SET SURVEY IN PREPARED,AND ON HIS DCHALF
TO THE TITLE COMPANY.GOVERNMENTAL /
ELEVATIONS,SHOWN HEREON ARE FROM ACTUAL SURVEY ADCNCY AND LENDING INSTITUTION LISTED • SUFFOLK CO.; N.Y. . , BY / TF• TiT�/r
AND ARE REFERENCED,TO,N.4.V.D.(MSL 1929 . - ,PrQOY HEREON.AND TO THE ASSIGNEES a THE
LENDING INSTITUTION. WARANTEES ARL SCALEI'i a%• /:;i;"+- DATE: - NO., a-a=023
' �.e t " NOT,7RANK[MBLC TOipD1TN)NAL 1 ■(�j.,I-- FI' MAR: 2"'1989-?r.Iy R9�.