HomeMy WebLinkAboutChierchie OFFICE OF THE TOWN CLERK • 'OfOUr`,O
Town of Southold - Z ,4• .
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road
, P. 0. Box 1179 113
Southold, New York 11971 .O` •
Telephone
(516) 765-1801 •
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 308 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool X
NAME OF OWNER: Steven J. N. Chierchie
OWNER MAILING ADDRESS: 817 Wiggins Street
Greenport, New York 11944
OWNER PROPERTY ADDRESS: Birdseye Road
Orient, New York 11957
OWNER TELEPHONE NUMBER: 516-477-2605
TAX MAP NO. :' Section, 17 Block 2 Lot 1 .5
•
CROSS STREET: Main Road
TYPE OF SYSTEM: Septic Tank New Existing
• Cesspool X New X Existing
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: N/A
eredefo;eoas„....eoo.„.•
Judith T. Terry
Southold Town Clerk
DATE: June 10, 1987
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK �FFOur
Town of SoutholdCQ�', Application No.00
Judith T. Terry, Town Clerk k _ y
Town Hall, 53095 Main Road c t . .G 7 Residential
P. O. Box 1179 � i y � � Non-Residential
Southold, New York 11971S•Qs
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to
Telephone -
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD. WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No3a S
Fee $ /O
DATE ( TIT?
OWNER NAME: G &) T t )
OWNER MAILING ADDRESS: (-4) .,
f 12-Y(1
OWNER PROPERTY ADDRESS: Sio-0 mac , er-'
b(Li ,U`" N , II`tS`")
OWNER TELEPHONE NUMBER: {��- � ��
TAX MAP NO. : Section 1 Block Lot 1 -
CROSS
-CROSS STREET: met.vv es_
TYPE OF SYSTEM: Septic Tank V New Nr'--Existing
Cesspool New Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: Al 4--
LOCATION
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:
F wn Clerk's ffice
DATE: JUN 0 9 1987
Town Clark Southold
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..The water supply &sewage dhposol sus- - - ' C � A 3� N ,
terns for this residence will conform to the ' "---- _... O
14cndords of the Suffolk County Depart- ' i N •
The water supply & sewage disposal�• - s-=�r__.. 7f - Qf ' ::r
tams for this residence will conform to the v _ ""�"` �; _ - _
standards of the Suffolk County Depart- 1 _ 4.ill .8 - ' __,
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„ SURVEY FOR &lG) ��s- al5l
DR. STEVEN CHI ERCHI E .
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CERTIFIED TO : TOWN OF SOUTHOLD ' "
FIRST AMERICAN TITLE SUFFOLK COUNTY, N.Y. - e
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- INSURANCE COMPANY _ .1000-- 017 — 02 01. 5 ..
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30.02' OF NEW YORK. rt t
TI TLE NO. 121 S 5532
Z HA MPTONS' MORTGAGE CORP. SCALE i = 30'
DR. STEVEN CHIERCHIE JUNE 2�4, 1986
Proparsd in accordance with the minimum
ut AUG . 4 , 1986 standards f�;r ti r•.,:�•N.,s as established by
oDEC . 29 , 1 9 8 the L.I.A.L. •-,;- rc,vcd and adopted
j.� - �/ for such use by 7l,„ f-.F York"State Land •
Title Association.
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ELEVATIONS 8i CONTOUR r ,`` • e2 ' N.Y. S . LIC. N0. 49668
LINES ARE REFERENCED + f1 ` ° fl e `
TO N. G:V. DATUM . �� �N ',,�
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MAINROA 0 p. p NSE. 2/24/07 " 1'. I 76rj 6$ �y i 0
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