HomeMy WebLinkAboutConlan SUFFOc \
°yam►
ELIZABETH A.NEVILLE I c . , Town Hall, 53095 Main Road
TOWN CLERK ti Z P.O. Box 1179
O $ Southold,New York 11971
REGISTRAR OF VITAL STATISTICS /
o aill Fax(516)765-1823
MARRIAGE OFFICER ifi�
RECORDS MANAGEMENT OFFICER
___ 49
1 �,��1 Telephone(516) 765-1800
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. 3807-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner CONLAN, CHRISTOPHER
Mailing Address 1 P. O. BOX 1021
Mailing Address 2
City St Zip SOUTHOLD NY 11971-0000
Property Address 1 1050 CLIPPER DRIVE
Property Address 2
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 516-765-6506
Tax Map No. section 79.00 block 4 lot 17.006
Cross Street ANCHOR LANE
Issue Date: 8/13/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
s If
• . ,,•
OFFICE OF THE TOWN CLERK COMA' -
Town of Southold �4% 14---_\ Application No.757
Judith T. Terry, Town Clerk • y
Town Hall, 53095 Main Road $10.00 - Residential
P. O. Box 1179 Cr] iii $25.00 - Non-Residential
Southold, New York 11971 4,y�� ''` . .�`�
Telephone _./ * .�0 OE
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.' F07
Fee $ / ,0d
•
DATE 409,/ /918
OWNER NAME: h/i-1 5 7-0p/1 e/ ai9ZA-4
OWNER MAILING ADDRESS: 6:?, 6 4k' /b
&o oYha/ci , /tJ\/, //9?/
OWNER PROPERTY ADDRESS : �0,S1) CL i ��QQ_-
C�a�' o 6-)4e
OWNER TELEPHONE NUMBER: 24'6*--,,- (D S-0 4,
TAX MAP NO. : Section .2. Block 1 Lot / /- 6D(.
CROSS STREET: ,9f C40 I . ,e,9-)i
TYPE OF SYSTEM: Septic Tank New !/ Existing sting
Cesspool ,New Existing
Residential V/
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.)
af"--176r;t2.2--....___
z
Sig ure of Applicant
RECEIVED BY /4 /
T 9wn Cl;_ k's Offic
DATE: 'V) A
'
Lal. `
83
56.'/. P,p,%= SUFFOLK COUNTY DEPARTMENT OF h EEALT H SERVICES
\ .
/ 6. 9 '
i APPROVAL OF CONSTRUCTED WORKS FOR
A S11�TCL1 int, ThI d F fDENCE
�' Datc.,1 1N 1998 /Ls.get No. RiQ 9�O—4e,9-5.j p�vE��
1 The sewage disposal and water supply facilities at this Location have been
h.
inspected and/or certified by this Department a other agencies and found to .
1 be satisfactory FOR 1 +ot i Oi?fod D ROOMS
to Qj St` hen A.Costa,P.L.,Chief
liki -1 s` O ' Office of Water and Wastewater Management
• ►� ,
7 1., iiR ,
c
a 1Z
I
Unauthorized alwadon or&Malan
4, `!�
) &am 72:11 altiUwwbsw
•
` E onLa `
of? - Cecile el ildeureepimpastlemlne
saviors Mee
�
4 4. Le iv, �'
i �` ilKS ia
+obawYt�� g., .1
"
0 d
�1 or�btl+e M/MIiMIME�1eM •
_ i;i P.•;' 7r
1 Is prpara&dde armory,O�..w,rl.. ►oN Q f All r%4
N t to additional instivarantees aro tutions or aubIUIat 9).
® o owners. OIL.
N E W Y OQ►'d
� N
- e'E'V fY POZ, ''4,.AwyvAzerxe. eoNL4�/
°=` ' -`,_ x/6-7`0 33#3 >.' ler•ez JlArPdf/4 eI/6.vr54sx.OTa'3�,14-e.3��A 7To3
,-/e/4,1 ,?y ��s►riav Sov>.u�tv/✓u�.Co Cavus;M Y, ,
? �•11_, �'J �'iY,Q/37"a oiY jz.1 j�BL�Yr�H/�+.O�,P.Yyt!
8 ,e4,40 /1/.9T/aa94 .9.elW4 41041.e400 Ti'«/i 455.4 4u. 4-erao9/onwr
orf l �/Yer O,'4�i odE,� Z2/
tN
19�f .97
4,0Av 5e/.?YtrYcte ,ee A4711,1.0wh2G./.od/, / is
1941.4cou�� X14 MO
- SRO aile1
- ,-.. _ \----_____ G Al/ /QG� �4 "/Iili 5oeiTVot13iv Y//f7/ �1 "s o8 - md�yP�
1 > 7f 4/