HomeMy WebLinkAboutBoner s -
r-N. le* \
JUDITH T.TERRY Town Hall,53095 Main Road
tA
TOWN CLERK ® ., toec14
P.O.Box 1179
t'P' , Southold'New York 11971
REGISTRAR OF VITAL STATISTICS (
NMARRIAGE OFFICER ®" Fax(516)765-1823
��
RECORDS MANAGEMENT OFFICER 14.80 Telephone(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. 3359-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner BONER, BARBARA C.
Mailing Address 1 P. O. BOX 73
Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
Property Address 1 1900 GRAND AVENUE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-5096
Tax Map No. section 107.00 block 3 lot 7.000
Cross Street GRAND AVENUE AND MAPLE LANE
Issue Date: 6/20/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
O(r►FICE' OF THE TOWN CLERK ,c��FFU(,-•'=
Town of Southold &Q * Application No.3•�S�
Judith T. Terry, Town Clerk y
Town Hall, 53095 Main Road 8 1 $10.00 - Residential
P. O. Box 1179 cni �` $25.00 - Non-Residential
Southold, New York 11971 OL **$
�j�i
Telephone e/ * IA/
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ /0
DATE (o7/y/9J�
OWNER NAME: lj 0. �ic%72
OWNER MAILING ADDRESS:, l)
OWNER PROPERTY ADDRESS: '19 O c p_A--c•.AQ Vv .
rY\ r 7-c-ccex— 12
OWNER TELEPHONE NUMBER: ' ' w 9
TAX MAP NO. : Section /0 7 ` Block 3 Lot 7
CROSS STREET: c� (J, <4-- 0(14-PLL.
TYPE OF SYSTEM: Septic Tank New Existing
•
Cesspool 1:C New Existing
Residential X 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.)
Signature of Applicant
,,
RECEIVED BY: ' ••
`
Town Clerk's Office V
DATE: ' '
r
1..1 V e.
Nay '�.71W4.
0 I
1-J I
1 I .J
A — "I.i;', (%c.• -fit°' AVE_ 14il f -- 0I.•'Vcr lc'
- ( __
ri�ad
I I N. 75") 44 ','L' -�• 150.00 /
T I.1
to .. _ _-
/\
'I i tri
I 7 W
1 tL. v1 I
V
I.!
I ''..s 11 I 1
1..it 1L= ---I h
I 4)- i f -.1 1 C)
N
1 it ii m
/ ,
1 v.l F __ o
I I I 5.75 '44'00"W. • 150.00
1
i
I J p
lJ. let i X1;2 -..
r, l!
1
i
lN
I
r
`1
i,
,, MA P OF PPIJPF r7-r''
UNAUTHORIZED ALTERATION OR ADDITION
5(J2 V EYE D F02 TO THIS SURVEY ISA VIOLATION OF
SECTION 7209 OF THE NEW YORK STATE
EDUCATION LAW.
/1 /34.,iR�/s}�' C^ O/,/�y`/M E ROPIES OFST YCYUR SEYPM P HOOTT BEARINGTHE
—"--- -'- -'- EMBOSSED SCA:SNAIL N•iT BE CONSIDERED
'
14 r TO BE A VA.10 I UE •PY.
A4AT
f / _// GUARANTC'S IN'.)•._4'C: ,'LET EI SHALL RUN
'�' I i l~7 / ! IJ I'yl• ONLY TO 111: •! 540, ;49 r,.v'A THE SUR EY
IS PREPAM.D, A 10 Oh 11.5 c. 110 THE
TITLE COMA•,, .,',V.N 4-I .A.AGENCY 011
0
7-0 IN IV )F `'Ourii014), 14.Y. LENDING I.`•S1.1 i1 . .. H.EION, AND
TO THE ASSIGN:ES 'F I.E LL.•D.NG INSTI•
TUTION. GUARANT`_CS ARL NW TRANSFERABLE
TO ADDITIONAL INS1IIM IONS OR SUISEQUINT
OWNERS.
vCL.I.G . 40' I.,
L
6ziaea1 feed 1-::, .r..-- 4,rty plzs d /nc.
0 = &ionorient
atfd ea Sou-t hold Savi11gs Barfk
.a.t stirvc Jed Marie? /574.
1 = Pike b
GlIce� seJ I.4 rid Jur�veyors
Greer/A(3eI, N.Y.
'
.. -
A • ,