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HomeMy WebLinkAboutBest II 0.11 Town Hall, 53095 Main Road ®fir' P.O. Box 1179 ���� Southold, New York 11971 JUDITH T.TERRY i /��,��� TELEPHONE TOWN CLERK (516)765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 805-R Residential X Non-Residential Fee $ 10. 00 Septic Cesspool X New Existing X Name Of Owner BEST, FRANCIS J. Mailing Address 1 P. O. BOX 873 Mailing Address 2 City St Zip MATTTIUCK NY 11952-0000 Property Address 1 ALVAHS LANE Property Address 2 City St Zip CUTCHOGUE NY 11935-0000 Owner Telephone No. 516-734-7012 Tax Map No. section 102. 00 block 4 lot 4.000 Cross Street ROUTE 25 Date Of Last Pump Out 0/00/00 Issue Date: 8/29/88 Judith T. Terry Southold Town Clerk (TOWN SEAL) • OFFICE OF THE TOWN CLERK cOHUI- • /��/ �, TUwn of Southold Application No. 5 Y' Judi`t i T. Terry, Town Clerk / � � L1 Town Hall, 53095 Main Road o . . P. O. Box 1179 � 4P-0, :--; ;� G Residential ; Non-Residential Southold, New York 11971 O ' ‘C-,e`� Telephone yid • (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ I'�} °°� DATE - ®` ` OWNER NAME: OWNER MAILING ADDRESS: (::2 ®.X I'vl cfv c 1 ,&dy OWNER PROPERTY ADDRESS: Ai- VIA t I4 $ e ° e /4/1,4( OWNER TELEPHONE NUMBER: 1734- t7f1. O _ TAX MAP NO. : Section Block Lot I,7 CROSS STREET: SAY Af'e - Aktik IONJ t:V) g •v Rize-N" TYPE OF SYSTEM: Septic Tank New Existing Cesspool New Existing p Residential Non-Residential DATE OF PREVIOUS PUMP-OUT: 4 - ®Z 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.) • jAa4/14._;e_i rgbedSignature of pplicant RECEIVED BY: Town Clerk's Office • DATE: `. L II �1°cn , .4 ,,Lw ROI' °gy for esIc Z° 9i 0° Of 001.Qn P:4....LLQ ronKllr1519 0 Jo 0 F 13 -`' 60 0025 (me�� s (. • {o • I0 O CO M7 -1 N01 0� LLE £ -t L a 3 w • w o .600 0 mO_/ mssco. tt�• -37 1 e e s-, 5 4 ,, a no 95o e. GP ' 0. 1 lihk I , • Qi s CA Oea O CD - • W- O -'Z �ssN z .c zr-' ' a, o(";, 01 0 06 10 135 Im - CA 1c /]p 0°oo IL v N- 0 00 �K,ln. 60 Z Z.r• S 10r-2' .to Or IJ - o 0o nnU 1MORILED ALTERAHON OR AUDIIICA O THIS SURVEY IS A VIOLATION OF CD ACTION 7209 OF THE NEW YORK STATE DUCATION LAW :OPIES OF THIS SURVEY MAP NOT BEARING HE LAND SURVEYOR'S MED SEAL OR MBQSSED SEAL SHALL NOT BE CONSIDEREE YOUNG ') BE A VALID TRUE COPY YOUNG & ,uARANTEES INDICATED HEREON SHALL RUN .NLY TO THE P RSON FOR WHOM THE SLAY, 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK J RE'AR9D, AND ON HAS BLNALF TO THE `LE COMPANY, GOVERNMENTAL AGENCY ANL SURVEY FOR a� •A)ING INSTITUTION LISTED HeREOty, AND . »+:r> THE ASSIGNEES OF THE LENDING INSTI• .. 1, GUARANTEES ABt NOT IRAN*e4RABLi FRANC/S J. BEST B CON / , .1 " - v °I'''',..;' . T k,cFlltcM CUTCHOGUE i,.o�N O�� 4�", TOWN OF SOUTHOLD r ,e ' SUFF. CO., N. Y. GUA -AVI I EE 4i ' NOTE' F AI', /S : ' ', 1 /= MONUMENT SCALE- / "= 40' C,ON'�-1N ' 4' 41 '° SEX+, , 0R ' E Cr , SUFFOLK COUNTY TAX MAP FEB. 26, /970 �� Baa`' 4° DIST /000 SECT /02 OLK. 4 LOT 4 MAY, 8, /970 lit. l- d JAN. /5, /976 ALDEN W *4 0 ' JUNE 7, /988 PROFESSIONAL ENGINEER AND LAND SURVEYOR,N Y.S.L/C NO. /2845 RIVERHEAD, N Y. NO. 76-8