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HomeMy WebLinkAboutBerkhan - -- t• OFFICE OF THE TOWN CLERK • Town of Southold � CcG Judith T. Terry, Town Clerk Z r . :; Town Hall, 53095 Main Road " ° P. O. Box 1179 `Ill M ` Southold, New York 11971 �- Telephone (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 313 Residential X Non-Residential Fee $ 10.00 Septic Cesspool X NAME OF OWNER: Thomas W. and Theresa E. Berkhan OWNER MAILING ADDRESS: P.O. Box 385 Southold, New York 11971 OWNER PROPERTY ADDRESS: 385 Shepard Drive _ Southold, New York 11971 OWNER TELEPHONE NUMBER: 516-765-4320 or 1862 TAX MAP NO. : Section 78 Block 1 Lot 18 CROSS STREET: Glenn Road TYPE OF SYSTEM: Septic Tank New Existing • Cesspool X New X Existing Residential X Non-Residential DATE OF PREVIOUS PUMP-OUT: N/A it ilre6° Judith T. Terry Southold Town Clerk DATE: June 23, 1987 (TOWN SEAL) S '00 ID III II _ OFFICE OF THE TOWN CLERK ci\VFD(,' Town of SoutholdQ CQG; Application Judith T. Terry, Town Clerk y Town Hall, 53095 Main Road gT '; :'6 Residential P. O. Box 1179 cn ! Non-Residential Southold, New York 11971 Telephone Q( i �� r' (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit Noa/23 Fee $/()•' DATE one i 1 , ) (j ) OWNER NAME: [ to q�a.S W �I �reS £ • BCfk,116,./\ OWNER MAILING ADDRESS: 'P , O . CJ o ( 3 g5- St) d 5'Soo 1, 0I � , . y. / 1 '1'11 OWNER PROPERTY ADDRESS: 3 g S Ji e p ca r� f� V Sov—��a ► , / x / 97 / OWNER TELEPHONE NUMBER: 65-- ,3 O or 6 5- / 2 TAX MAP NO. : Section 1 Block Lot g CROSS STREET: G- cn v\ p cA_� TYPE OF SYSTEM: Septic Tank 1,7 New ✓ Existing Cesspool V New Existing Residential ✓ Non-Residential DATE OF PREVIOUS PUMP-OUT: /V ,9- 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: Town Clerk's Office DATE: • . _I • ,_... . .. DA12 7 - - : VAC.- . . 0 , 0 ,, 5,72 59-30 E. . 170,00 9? — - '(:•- . .., POOL.f.-.:, --- • . o ... ' 0 , , r- i • c. A .;- c:• t, `I- / _. _ „.--A..,r: . , !...,. _ , , ,,,, c____:— cii • ,ft „ . . .. , :-.. .,- ...-7, - .• , -(•i 61 , , .11/? ST024' - .„ • ;4-4 f 1---32• f-1Q,, I - _. VAC. • \ .>, . , i •C-Ac , 1 . 1.• - - .. .. . .,. , \ -• _7........._....1 1St; , . . \ •.. I 100 ., -v?• v,,,_/ , .. . ...„. . , -,sk\ , , k..,1 wEL L. :-‘:\g( (4) -I ,. \I” ' . , _ -- . , . . .t ---- N.722'59'34"\Ari ' . i i ca co.9 , . /0- • tai •F.A-I El PA2..ED -. ,L--.)ra 1 v E 94. 5o' \-e, -..- • ....._ ...: , , •-...,.. ,__.„ . L__•,, ..1-, • . .„,...„ v. , . • . 0) - ' ,-,__ • i .,......_4- ' — 0:. -• r __ ___ . .. • ,_:,. ,,.: i .. . , , , - -... - - -/ . . ' . 1 f s,1 . N3)..rES 1 e•-,-,-.:-.... , / - ,.,,, .,,',..-,::::',•-•, • ' ' . • ,, Q.:,•'1-`,;:. ..:• -, .„ — • 7, '- i-Lor 1.,•101:,1 r2Epc.c. - . - . - .. . . . . ...,.......—. - r. ,-- . . _.. 1 f\I THE-,,SUFF.. a). >::'".i.',y,v.1-!• -...,1:''. :_.;.- • . - _ '.- -745:. •. - 2:EflEIN•Artolv.:s•B -,-...:4-:::;-4,'.• -- ,. 1 , , . . :, . _ ____:.............., . -:-'‘,z-'3,1---,-.•-. ...,.:-, _ - -- , ,'.'..7.---Q.es, ' - - • . ..; • , ..?4,:-..-,4!„,•-. ,,,., I,.•-•• ." , —• ' .' ..• _ • . • I. • •.. . • - , 9*‘ ''.•4•. ' _ — . '. . — • • .Z1:12,•.r."—•••"-•••.‘• 7:',S., .•-•, i.,.-— -- i,.. •A:, .,—,.. . . . OF p . r-17-142-j- /. ?,:a=,-ii?..--- --,;,--.,.. '-„,-,..'.-..,'....-_•:;,-.., ' ,..C.iri:9\f"'" -. - 7'. , 12,0 Pm '.. \f , • . • . . . . -.,:,..-•,-..,,. ...:,-;:....!‘.P...?,-•,,,. :,..,..,,..,-...,.„ , - . .-..:, :st.)1ZVEY.EV.- Fr...112:4-1',-- • ' .:. •-•%. A NA_ . .. - Ri'- . '.„ ., 1,:;.-,:5 ,, . N,.s4.:., . . ......._...........;,..........____ . . , . A•41" ,-5 ' . , . , • — .., .., . .. • . . . ..,_ -• - I, -1.7;,•:Olitf-,10 L.D ... . , . , . . . .. . ,..:„..F.-„,,, •, ,,. ,. ..r. _ •,:_ . , . . , - -..,.3...,,.-,,•,•• --., ,23:0 /N105:.41.5,,I. if rr-'40: i.) 'N''y ....___......,..., • t,,..,....._-.....,... • . _,...-.•-,:-..;-,?.. . • _. , : , ,...,4T if;•-•--,-. - -:., ,' • , • - L . 1.::;•.•:-... . , . - , f. ,,,,.0-,,,,•;/-:,..... ' . „ ..., - -, ,,, - , . . .i^ ,-,..,t7................,/, r. .:'''" '• , - . . . ." •- , ''''-‘,—.2'il,.'t.i..Ir.%‘-t_..` - -- . • " - — 2 ' , i,YZi-t,.,t0;e•/ - -.7 crttrAlit MST.: N32477 . . 7, —