HomeMy WebLinkAboutBertorello OFFICE OF THE TOWN CLERK I Ir\\VF- x`,"
Town of Southold ,- 40
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Judith T. Terry, Town Clerk Z
Town Hall, 53095 Main Road ,
P. O. Box 1179 `5
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Southold, New York 11971 pA
Telephone •Zi �•
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
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OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 300 Residential X
Fee $ 10.00 Non-Residential
Septic Cesspool x
NAME OF OWNER: Robert and Nancy Bertorello
OWNER MAILING ADDRESS: P.O. Box 1451
Mattituck, New York 11952
OWNER PROPERTY ADDRESS: 1800 Country Club Drive _
Cutchogue, New York
OWNER TELEPHONE NUMBER: 516-298-5596
TAX MAP NO. : Section 109 Block 3 -- Lot 2.18
CROSS STREET: Linden Avenue AKA Moores Lane
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New X Existing
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: NA
Jud tii Tom. Terry
Southold Town Cler
DATE: May 5, 1987
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK COFUte�- �D�
Town of Southold �® � 4 Q ',, Application Noc
Judith T. Terry, Town Clerk d ,�-
Town Hall, 53095 Main Road '-" --.4• 1 Residential
P. 0. Box 1179 cn �i �� a ' � Non-Residential
Southold, New York 11971 % 4'(zzt;. • `
Telephone o� ��
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE 711.C(,d 5; 1 R se 7
OWNER NAME: 11:0gEtE r d ,Vr9AlOftdi Ofc' �LLO
OWNER MAILING ADDRESS: PO • 130)C 14154
mcc++e`4e kk , Al-U. /)9
OWNER PROPERTY ADDRESS: I Ro 0 Co L__L Ar •4-2 Iu la 1")2CEJ
C uLiLCk O tL P, , • 10,3
OWNER TELEPHONE NUMBER: o 1 - 5 C1 (�
TAX MAP' NO. : Section s ®ct Block 0 Lot 0,2,
CROSS STREET: L , n(Ln A-0 a • tIffig moors LCu-,P-
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New x Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT:
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:
RKovthown Clerk's Office
DATE: llnI►Y 0 5 1997
Town Clerk Southold
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES EASEMENT--" 0,.. SUFFOLK COUNTY
FOR .F. .C•V/'.L C ccr-77.,:CTGN CNLY S �fm� C/
IZ \ 7. DEPT. OF I-�:A!TF1 .
T ,86 � �� ,, E• � �R=160.001 4. .- RI J' Y 1190'1
DFTE // I C. f MARSH AREA LOT 18 ,:`Lq L= 2 .00 �'LUe 2L 2 29 ,�t� est
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-/ MARSH I 033 NYT? inZ' -
AF PROVED �--
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401. 53, Ago o3 26
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-e 195.00 ' -' (0' i X3,37 �nn �` \\� 406. 63' 25
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M se/bac F /ii7e is rn ,..q)M 7'S ' -� n - the water supply & sewage disposal sys- n O
terns for this residence will conform to the
Q .�o - standards of the Suffolk County Depart in
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o_ 7. ment of Health Services. o Z
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find 1
art(34v 487.25 c;1°5
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Cozrse __ — 3'40 "w• SURVEY OF
_ s. 82° 5 lNC. LOT 17
/ O�'• �e N 0 R T H FOR C OU N TR Y Prpih4F i accordance witl, the mi.-I um tt •
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standards for ti'' ; y, MAP OF COUNTRY CLUB ESTATES
�+ �QNA. 4 ,0 N /OAF the L.f.A.L. ,. y
reJ FILED OCT. 17 1978 FILE NO . 6736
, g. r�/ for such use by 't u: ,ew arrd
�+ .� 1. • O / Tdle Association.
AT CUTCHOGUE
Nkfr,irs CERTIFIED T0 : ,
° } TOWN OF SOUTHOLD
CHICAGO TITLE INSURANCE COMPANY
Q� ROBERT J. BERTORELLO SUFFOLK COUNTY , N. Y.
So hiC�,,�0 N.Y. S. LIC . N0 . 4966 6 NANCY J. BE R TORELLO f000 - 109 - 03 - 2 .18
PE CONIC SURVEYORS a ENGINEERS , P. C C . SCALE In = 100
( 516 ) 765 - 5020
P. 0 . 80X 909 JULY 14 , 1986
MAIN ROAD AREA = 145 , 161 SQ . FT.
SOUTHOLD N Y 11971 OR 3. 33 ACRES
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