HomeMy WebLinkAboutBancroft /•,®s®�uFE0(,� O
JUDITH T.TERRY �� � y� Town Hall, 53095 Main Road
TOWN CLERK ; P.O. Box 1179
I) 4 $ Southold,New York 11971
REGISTRAR OF VITAL STATISTICS ` ® Fax(516) 765-1823
MARRIAGE OFFICER % �iij'® NO.. 1
RECORDS MANAGEMENT OFFICER
Fax
(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. 3429-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner BANCROFT, MARTIN J., JR.
Mailing Address 1 P. O. BOX 2060
Mailing Address 2
City St Zip ORIENT NY 11957-0000
Property Address 1 5305 NARROW RIVER ROAD
Property Address 2
City St Zip ORIENT NY 11957-0000
Owner Telephone No. 212-772-2511
Tax Map No. section 27.00 block 2 lot 2.003
Cross Street PLATT ROAD
Issue Date: 1/29/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
I
OFFICE OF THE TOWN CLERK ci\FFOLA- '-
Town of Southold � CQ ' Application No. 57
Judith T. Terry, Town Clerk �� 41\
f'
Town 17.aIL, 53095 Main Road a $10.00 - Residential
1111: 0. Box 1179 v' hi ;' $25.00 - Non-Residential
Sou'thaid, New York 11971 OO �0*"$
Telephone _ ,( `t
•
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
•
for-
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE 0,,(0 (9
OWNER NAME: ASke(-TIN , 2.poc.. cF-A-
OWNER MAILING ADDRESS: P,O_ BO x �C:)lo
KY k c\,5
OWNER PROPERTY ADDRESS: j ���® w CZ( U6?., �
s,.s
OWNER TELEPHONE NUMBER: .9 ( 91
TAX MAP NO. : Section - Block Lot �•
CROSS STREET: 11111' S tinIA_ •Cjkvit • �2 ,
TYPE OF SYSTEM: Septic.Tank New 1/ Existing
Cesspool New ✓ Existing
Residential 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.)
Sig Fiirr Appli,ant
RECEIVED BY:
Town,,Clerk's Office -
DATE:
.
��
.. • :, 'Se® e� t,
• '��() cr a �Q°
. . , _ i 3`.-45)yam' /I\
�° �? o`er/� \ \
e�z , �S e I \
0 n a I \ , '••i
° SJ. ti N
e4 /I\, I 1 L, ; .+
°� �? I \s 1
cI
,go I �, `` VcA 1, I I
\ I--
• _CA
\ , INSETN.
Fps SCALE ,• = 40'
a
a a°� •
0/22 ,or ,
. .Q .erg , .
/
I t7 /
/ _ • ,I
SF s.''
' / ;}}
eo F,�SF), sjs� /
q / .
o4,i- , -74f )^.- F
� / <I\ �'90
/
e\
oa
q
, \ ' /� • .{
~eo
I,'� \\\ pr 4 Cit / Fp 'or
. a1 6) ?9 3 >g / �Q
.� )023 �s9. // o,7��jro `1.0,�
'�F•O� \\\\ ��'?� S Cil`Q�hO/ory
y 1y • \ y171S Oci9��1, \\ �s °65 (7
�/ '
J • , - ictiC q�FR .1f/j•- \ ' -
tc
p0' •,99O, l,9NO\ \ , ,
/ - ' S
,o 4,
\6500 - . POND a
1I0FG9� \ 6,94,
� " . f
�O,Q \ 67.27' 9
,y/06, . • , , \ N\30,, w \ \ 'POND,
od'8 qr \o0•op, j
. / \ ?g•e \
\ \ d
\ W
o/< /3 \ 187'•82' `
/ MFNT \ \ssp 0C
•
2 r, ,. : i
• I
I- {
•
,
t