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HomeMy WebLinkAboutBeaudry OFFICE OF THE TOWN CLERKF� Town of Southold �� C�y Judith T. Terry, Town Clerk Z �' Town Hall, 53095 Main Road , P. 0.' Box 1179 4C._ ''k: Southold, New York 11971 om,' ; ��- Telephone _alt (516) 765-1801 /*- TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 218 Residential X Non-Residential Fee $ 10.00 Septic Cesspool X NAME OF OWNER: Joseph H. Beaudry OWNER MAILING ADDRESS: RR1 , Box 160, Bray Avenue Laurel, New York 11948 OWNER PROPERTY ADDRESS: Bray Avenue and Sixth Street Mattituck, New York OWNER TELEPHONE NUMBER: 516-298-9141 TAX MAP NO. : Section 126 Block 1 Lot 13 CROSS STREET: Albo Drive TYPE OF SYSTEM: Septic Tank New Existing Cesspool X New Existing x Residential X Non-Residential DATE OF PREVIOUS PUMP-OUT: November 24. 1986 GOreed°44.1;ef...4 Judith T. Terry Southold Town Clerk DATE: February 9, 1987 ,(TOWN SEAL) so Or OFFICE OF THE TOWN CLERK0FU Town of Southold %c. { •; COG Application No. lv Judith T. Terry, Town Clerk ' .G I Town Hall, 53095 Main Road Residential P. 0. Box 1179 cn f ; �` Non-Residential Southold, New York 119710� titlo � �1`� Telephone -1,0 1► � • (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICAT ION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. C2--l/ Fee $ (.ot ©O DATE f-e / 6 — 7 7 OWNER NAME: J c SCJ Gt f{ f e /4-CA ky OWNER MAILING ADDRESS: /2I I Box. 26 ,0 f3 vIL V Az () G. /14Ya / ( Cy OWNER PROPERTY ADDRESS: Le y/ G4 L/ 67441 5 "1"-- /14- 7' 7'It' '"-- /94- 7' 7`It' ck / / � So2 OWNER TELEPHONE NUMBER: . 7 — 9 I I/ TAX MAP NO. : Section Block I Lot 13 CROSS STREET: ,4I /3 Q D V ( V �- TYPE OF SYSTEM: Septic Tank New Existing Cesspool \' 5 New Existing d S Residential \I -e 5 Non-Residential DATE OF PREVIOUS PUMP-OUT: I a F 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:C . REcEivEATown C rk's Offi e DATE: F R 0 ® 997 Town C rk Southold • • 111 - 7 - - - ••.a c •-- Ai • • • • . • ®. � t F �� i' -to o % '' - •34-61' . -: .- EL-61'%4;-1 Cfr' _ . . . ., , _. z...._.....„Egms ,_,....._,,,,______,. ._. [5citaY / _ 1.0 ._:=13 . .- D - ' / - , / .. tin� •� '� • = / _ SCA( E-4Q1 ' 3 N Q 5OE�:7-7 �; j , / �l `' fSCQD . v� 5 SfK? �f `TWEET 1 - • • MOTE-LOT NQ'S.P.EFEIZ T4°sl,$DJVI5 ON MAP-SECTION r �Nt:,PR0PEQ;/OFG.i.TUTUILL+fC4'"i''F;:_ED!N 493 SNE 5!lFPG1.V COUNTY CLEW'S QFF!_CE !�S!�tAP 1 MAP- N--* I P. OPE .TY SURVEYED FGA •• - SUFFQLi CO.TAX PI AF DESIGNAT�oN.: - • ��--P � ! j 4` f+`�, j 'In t -j nr � piss, loco1SEC7:i26,Bi—),LOT {3. - . Lit,' F ! !•-+ t :- VNAUTHORIZ _ f 1 !. ,;-,.....!!--\,... a #. it )'_ i s f'� i - �Olt ADDTTIOK-- .•� 1�. 1 i. - 1 TO THIS SURVEY IS A VIOLATION OF AT - ! SECTION 7209 OF THE NEW YORK STATE p _ i EDUCATION LAW. N;A 1 1-'i t.�� ._� UAP_AN EE.J TO IA E .]U?-�-i+:LD 15AV1 mc;s BAN4!,. I s COPIES OF THIS SURVEY MAP NOT BEAR?TOW N OF �+LI IL( 1 y - GUARANTEED TO 114E-CHtON O TtTLE{Nst.;RANc COlv(PANY 1 LAND_SURVEYOR'S INKED SEAL OR �l ! • ' - AS SURVEYED E -- _ ,0 �g,i .� EMBOSSED SEAL SHALL NOT BE CONSIDERED _ BE A VALID TRUE CCPV. • Ar)O(1 j I / �� �y `C ' , UARANTEESINDICATED HEREON SHALL RUN - `.NUr TO-THE DEFSON FOR WHOM THE SURVEY - • :_ - - - S MI ABED,AND ON HZ EEHAIf TO THE -V :r- + . COMPANY,GOVERNMENTAL-AGENCY MO - -. ' ' •NG.at6TLEllpON rum HtifON Ago • - - - -- ` O fl ASslc, CF m B LEt.�dDEC iMstb LICENSEE) t�lF3 ' �,tp� UT OJ GIJARMriffs ARE EQANEfismi • `. : .' s �4 i i , •- r w � Air 'f'R ' 4EvAPOR T�l�Y, +_;_ -_