HomeMy WebLinkAboutCrowley (2) /�-00,0
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ELIZABETH A.NEVILLE •�W �®� :P • Town Hall, 53095 Main Road
TOWN CLERK ; ® a
P.O. Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS , k` 3
. �� Fax(516) 765-1823
MARRIAGE OFFICER . �,
RECORDS MANAGEMENT OFFICER • 1 !MS coir Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER = � f
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3781-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner CROWLEY, PETER AND LORRAINE
Mailing Address 1 65 ROSEWOOD DRIVE
Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
Property Address 1 65 ROSEWOOD DRIVE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-5361
Tax Map No. section 113.00 block 2 lot 15.000
Cross Street COX NECK LANE
Issue Date: 4/10/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
.411" • „
OFFICE OF THE TOWN CLERK �c0F0t/i/=
Town of Southold S$ CQG= Application No.-3> SS')
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Roada - $10.00 - Residential
.
P. 0. Box 1179 tri •• - ` ;'
$25.00 - Non-Residential
Southold, New York 11971 O ' s'
Telephone Telephone =�j * A0
(516) 765-1801
• TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE April 2, 1998
OWNER NAME: Peter and Lorraine Crowley
OWNER MAILING ADDRESS: 65 Rosewood Drive
Mattituck, NY 11952
OWNER PROPERTY ADDRESS : 65 Rosewood-Drive _
Mattituck, NY 11952
OWNER TELEPHONE NUMBER: (516)-246-5361
TAX MAP NO. : Section 111.0 Block 02.0 Lot 15.0
CROSS STREET: Cox Neck Lane
TYPE OF SYSTEM: ,SepticTank New Existing
Cesspool New XX Existing
Residential XX 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.)
Signature of :S pplic.
RECEIVED BY: tZ)/(L.....1---2--tor .
• Town Clerk's fice
DATE: ��
SCDHS REF. NO R10 - 96 - 0114 �:_;, elf.,,,r r ' ie; `
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AREA = 20,470 sq fry�= .
.The locations of wells and cesspools
shown hereon are from field observations
and or from dola obtained from others.
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I am familiar with the'STANDARDS-F
` AND CONSTRUCTION OF SUBSURFA
ANY ALTERATION,ORADDITION TO THIS '`
SURVEY IS A VIOLATION DISPOSAL SYSTEMS FOR,9E`;F
OF SECTION 7209 OF.
THE NEW YORK STATE EDUCATION LAW and will abide by the conJpt/o�as:sel•'•for:.
EXCEPT-AS PER SECTION 7209-SUBDIVISION 2. ALL CERTFICA'TIONS ermlt to construct.
HEREON'ARE. VALID FOR THIS MAP AMD COPIES THEREOF ONLY F P , -
SAID MAP OR'COPIES BEAR.'THE IMPRESSED SEAL OF THE SURVEYOR
WHOSE, SIGNATURE'APPEARS HEREON.
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ADDITIONALLY TO COMPLY WITH SAID LAW THE''TERM 'ALTERED BY' •
MUST BE USED BY ANY AtALL SURVEYORS'UTILIZING A COPY
OF ANOTHER SURVEYOR'S PTERMS SUCH AS 'INSPECTED'AND ; "
'BROUGHT-TO:DATE°ARE NOT IN COMPLIANCE WITH THE' LAW. ADD CERTIFICATIONS /2/17/96 -