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HomeMy WebLinkAboutBurden (2) ' Town Hall, 53095 Main Road crb P.O. Box 1179 li'• Southold, New York 11971 JUDITH T.TERRY 0.1 FAX(516)765-1823 TELEPHONE(516)765-1801 TOWN CLERK 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. 943-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New Existing X Name Of Owner BURDEN, MARCUS AND SHARON Mailing Address 1 265 EASTWARD COURT Mailing Address 2 City St Zip MATTITUCK NY 11952-0000 Property Address 1 265 EASTWARD COURT Property Address 2 City St Zip MATTITUCK NY 11952-0000 Owner Telephone No. 516-298-4318 Tax Map No. section 115.00 block 7 lot 1,0A0 Cross Street MAIN ROAD (ROUTE 25) Date Of Last Pump Out 0/00/00 Issue Date: 12/06/88 Judith T. Terry Southold Town Clerk (TOWN SEAL) • OFFICE OF THE TOWN CLERK c0FU(A- '- Town of Southold � 1'� Application No. (./3 Judith T. Terry, Town Clerk " VLA . Town Hall, 53095 Main Roadc=1 tS;elliat r .- 7 Residential P. O. Box 1179 u' _ Non-Residential Southold, New York 11971 O �,"t _jC" �•`� 4:6 !" •• Telephone ®1., [ �� (516) 765-1801 TOWN OF SOUTHOLD 04VVD SOUTHOLD WASTEWATER DISPOSAL DISTRICT Nov2 tOn APPLICATION Ism "u u , for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ /C'/.6L-0 DATE // O_S—Ak- • OWNER NAME: e„,0S -4- EhciCort titrke OWNER MAILING ADDRESS: a6 �a,clr " l c.olo /4 //9 a OWNER PROPERTY ADDRESS: OWNER TELEPHONE NUMBER: 676 99 - tiff peo -/(S- 7 -/® TAX MAP NO. : Section Block Lot CROSS STREET: A✓'otia' TYPE OF SYSTEM: Septic Tank New Existing Cesspool New `Existing )0' Residential X Non-Residential DATE OF PREVIOUS PUMP-OUT: /VMJG' fly©Cv,v 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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'- • `=; by locatton'from;',houso'owners-and;;field �F; iwA: Unauthoriiod alteration or addition''to this survey Is a violation of observation9,''sinco'mo$f wQlla,,nnd'ces'sa { • section,7209 of the Now •York State Education Law, ' ; 'nook,`aro�1bt,`visible';these.'i dimollslons,,- inked • • .,t '-`' - ; , ' ':. 1 Copies of this survey map not bearing the surveyor's • br'°,� rti(f,,,1" ,:J; ,} tt ‘' 1 coal cr_embassod seal,shali not be considered to' be a valid copy. �, •-t).1`;Y'; i, hereon'"sHall run only to the £z,, '''- `'i` i d - l3irorantFes or cuitiliccltiun? cldicatoc� Y '' >' �""r"�'"0t 15�� ;!; �� person'for whom the survey is prepared,and'on his behalf to the ,,", til-:. t .title 'governmental agency and lending institution listed '" {IK' µ' '•^"w'' '...,- -6' '-'.`' ;', company, t'r ,` ,:, '�,; .. �.t;� ;t;%:K;;r r., ., ;'! Guarantees ft � i"-r,,, ,,r:, _,. hereon,and to the assignees of the landing institution. �; ;" ;4 ,', ''�' ,•I',� _ ' ,.�'t '`` ;.�:'t','.^�} +�1�r#fir - or certifications are not transferable to additional institutions,or -'.,,,,1:• -.,,,,c AG, .?;a;, f} tr,. tt r t 'r,s,Y'�G, �;� ,Ss'�I °%y;4tnt t,"`i' ,`�''Fat,f t�S 1 SURVEY FO ' E ' REFEPRONFC,LrwA;r '°,n.;;;;, ;;;,, , ' �s11t JERRY HO d ;r151 . RTOFI LED JUNE 21 /9TI',' PiL'$' ND l 6a • ,` r=;x'�; '' . , AT AQTTITUCK r - r-•,•E, t 114 F , y ' 's. .; ._ ,;: ., ,• ,r TOWN OF SOUTHOLD ,-., . tf ;': ` I •,;'GUARANTEED TO; r ,,. , . ,..-.,: a3,,,:,, . a '? i`I` ,,,,,-;', ,,,,$,1:.,,,,,-;', ,,,,$,1:..•,c,,1,.., {BUFF®LK COUNTY NY . : ' t tr -..‘r7 F .. . y-°1� , `' 1 ' SCALEI , - , , ' � , ; '.„ ., ' ti1 „.„,:N, �,k . ; ,1 , . , .,, . ,.. „ , , .: ,. . , ,,, „-„ , ' ' ' ' LAND'SURVEY • '`;` ., ,,,, I' .,;a. ' NYs:''IJC.,'NO, s 725' ,0, q, `,1 ' ' ' , RIVERIHEAD' `N.'Y. 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