HomeMy WebLinkAboutAlexander OFFICE OF THE TOWN CLERK • • FU
Town of Southold � �� C
y , �
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road ,`i `"
P. O. Box 1179 �, cn at
Southold, New York 11971 QC - •�,
Telephone * 1%
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 474 Residential X
Fee $ 10.00 Non-Residential
Septic Cesspool X
NAME OF OWNER: Eric Alexander
OWNER MAILING ADDRESS: 4545 Peconic Bay Blvd.
Laurel, New York 11948
OWNER PROPERTY ADDRESS: 4545 Peconic Bay Blvd.
Laurel, New York 11948
OWNER TELEPHONE NUMBER: 516-298-8231
TAX MAP NO. : Section 128 Block 4 Lot 20
CROSS STREET: Delmar Drive
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: July 1985
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oredea
Ju dith 6 .
T. rry
Southold Town, Clerk
DATE: October 27, 1987 •
(TOWN SEAL)
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OFFICE OF THE TOWN CLERKF0(/{CQ
Town of Southold , ,--.`TM` G'- Application No. 4/791
Judith T. Terry, Town Clerk _ 4�
Town Hall, 53095 Main Road o "' � :'� Residential
P. O. Box 1179cn " �' Non-Residential
.
Southold, New York 11971 O ® . :�
Telephone 1
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. z-056
Fee $
DATE /16/,/,47
OWNER NAME: /offi C i7/PXQr)a/eY
OWNER MAILING ADDRESS: 5/5' t5 A"c0r7/C 6/
ZQwre/ /V. y //9i4
OWNER PROPERTY ADDRESS: U" / /c. i ,eUc/
L NY// 9SCP
OWNER TELEPHONE NUMBER: a/9f- i.93/
TAX MAP NO. : Section /a/J' Block Lot 02 O
CROSS STREET: Del ►77gr Di"io
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool ✓ New Existing I/
Residential V Non-Residential
— DATE OF PREVIOUS PUMP-OUT: 7/�s
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.)
f„--,fr • i 1 /
Signature of Applicant
RECEIVED BY:a_ , a 0 leA
wn Cy 's Offic` ____
RECEI�lEr►#o
DATE: OCT 26 f967
Town Clerk Southold
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_ . e.,,o =o REVISIONS YOUNG & DUNG
N.
°'FNo• a$&6��,CI
ssI' 4 0 OSTRANDER AVENUE, RI RHEAD, NEW YORK
/°NAL ENGINEER ALDEN W. YO G HOWARD W.YOUNG
PROFESSIONALS INEER AND LAND SURVEYOR
LAND SURVEYOR. .Y.S. LIC. NO.12845 N.Y.S. LIC. NO.45893
/
SURVEY FOR:
ISUNAUTHORIZED ALTERATION OR ADDITION TO ERIC ALEXA DER 8 MARYANVAL ANDER
THIS SURVEY IS A VIOLATION OF SECTION
7209 OF THE NEW YORK STATE EDUCATION
LAW
COPIES OF THIS SURVEY MAP NOT BEARING )641.b
'THE LAND SURVEYORS INKED SEAL OR
EMBOSSED SEAL SHALL NOT BE CONSIDERED
TO BE A VALID TRUE COPY AT GUARANTE A• TO:
' L:/UREL R/VERNEAG 'AV/ a BANK
GUARANTEES INDICATED HEREON SHALL RUN HOME T/TLE ION Of CHICAGO
ONLY TO THE PERSON FOR WHOM THE TOWN OF SOUTHOL T/TLE/NSURA C O. /
SURVEY IS PREPARED,AND ON HIS BEHALF
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