HomeMy WebLinkAboutYantz JUDITH T. TERRY ` Town Hall, 53095 Main Road
TOWN CLERK
c:3
m ` P.O. Box 1179
.� $ Southold, New York 11971
REGISTRAR OF VITAL STATISTICS = V �� Fax (516) 765-1823
MARRIAGE OFFICER Telephone (516) 765-1801
����
RECORDS MANAGEMENT OFFICER : Ql
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. 3256-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner YANTZ, WARREN AND BARBARA
Mailing Address 1 2345 PEQUASH AVENUE
Mailing Address 2
City St Zip CUTCHOGUE NY 11935-0000
Property Address 1 2345 PEQUASH AVENUE
Property Address 2
City St Zip CUTCHOGUE NY 11935-0000
Owner Telephone No. 000-000-0000
Tax Map No. section 103.00 block 12 lot 15.000
Cross Street DARTMOUTH PLACE
Issue Date: 10/06/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
�.eL
• •„.
.FJFFICE OF THE TOWN CLERK ,cOFf/ k�'=
Town of Southold -% - : 0 % Application No. ,52:54
Judith T. Terry, Town Clerk % N j,
53095 Main Road : '�° < $10.00 - Residential
Town Hall, a ;
P. O. Box 1179 ;.��r�; ' ` $25.00 - Non-Residential
Southold, New York 11971 O .'i,tr. .•�`
Telephone _ .( '�
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE
OWNER NAME: Warren C. ; and Barbara J. Yantz ( formerly Fleet)
OWNER MAILING ADDRESS: 2345 Pequash Avenue
Cutchogue, New YOrk 11935
OWNER PROPERTY ADDRESS: Same as mailing address
OWNER TELEPHONE NUMBER:
TAX MAP NO. : Section 103 Block 12 Lot 15
CROSS STREET: Dartmouth Place
TYPE OF SYSTEM: Septic Tank X New X " Existing
Cesspool X New X Existing
Residential X Non-Residential
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.)
EA ISLE CUSTOM BUI DERS, INC.
"1-44410
Signe of Applicant
Richard • . f) 4‘...........______ /4----,
isano, President
RECEIVED BY: (...2-1-e--12-'1--------
-Tow Clerk's Office
DATE: 7 /7 cf
c ,
ti
�4 N
G s
„/
esli
o' ct\i(rbk P y
r
o0
03• o,.
2 <.‘ Lar
V� a
Q:(‘ I\
O
\ . \PC
D0 t i-
•D(Dc3 -;{ �F-
ys. WO SURVEY OF
\ czLOT 1
°rhe '�� 3 �g-- __aD� q�/Fe1 �� "MAP OFBIG GREEN ACRES"
�y, '� `\ 2a. _ /°� y'9 FILED JULY 12,1972 MAP NO. 5757
Q1 R . ���� �. 4,,,; o��� AT CUTCHOGUE
/- ��/ O -9
4 Fso ,o m o� \ \ ,, o -A� TOWN OF SOUTHOLD
,,t. ,� �, �� SUFFOLK COUNTY, N. Y.
�- /, 1000 - 103 - 12 - 15
.9 �0 // 1 %D�ti /le
20 Scale : 1"
/ /
Q
, ,1e` to o, April 14, 1994
G �,�, 0� Aug. 11, 1994 (foundation )
-"V Fe S �� Sept. 21, 1994 (final)
1—
"5707 t
l' op / 0 4• G\P Ldn
��® �o Ja
e® /�p on D�62 10V� WARREN YANTZ
AREA = 39,864 SC]ff. o- 0 • V BARBARA YANTZ
USDA DMIN
4 ,. ti�i S.C.T.I,CARMERS. 33094E-A478/STRAY/ON �u1-gNo
ELEVA TIONS ARE REFERENCED Q. , ca��pNN T Mac `sG •
TO AN ASSUMED DATUM. .- 3 v -s • T? G
The locations of wells and cesspools ! 4- /'%' ' 11.{
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES shown hereon are from field observations cJ>> �t? •
and or from data obtained from others. ti " d
FOR APPROVAL OF CONSTRUCTION ONLY / am familiar with the STANDARDS FOR APPROVAL AND CONSTRUCTION OF SUBSURFACE SEWAGE Pre ared in accordance with the minimum /i\4it4s. LIC. NO. 496/8
R-10-940038 DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES standards for title surveys as established ".
DATE HS. REF. NO. and will abide by the conditions set forth therein and on the by the L.I.A.L.S. and approved and adopted "'CONIC EYORS, P.C.
permit to construct for such use by The New York State Land (5/6) 765 - 5020
Title Association. P. 0. BOX 909
APPROVED MAIN ROAD
SOUTHOLD, N.Y. 11971
94 - 166