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Home My WebLink AboutBransfield 1' JUDITH T. TERRY Town Hall, 53095 Main Road TOWN CLERK • ,u� P.O. Box 1 179 r-" .Al REGISTRAR OF VITAL STATISTICS `-n e3� � - ti;�a Southold, New York 11971 MARRIAGE OFFICER ;�� k ;�;Fs e Fax Fax (516) 765-1823 Telephone (516) 765-1801 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 1594-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New X Existing Name Of Owner BRANSFIELD Mailing Address 1 245-10 GRAND CENTRAL PARKWAY Mailing Address 2 APT. 2C City St Zip BELLROSE NY 11426-0000 Property Address 1 1780 HIAWATHAS PATH Property Address 2 City St Zip SOUTHOLD NY 11971-0000 Owner Telephone No. 781-364-9230 Tax Map No. section 78.00 block 3 lot 42.003 Cross Street NAKOMIS ROAD Date Of Last Pump Out 0/00/00 110 Issue Date: 1/17/91 Judith T. Terry Southold Town Clerk (TOWN SEAL) Of • OFFICE)bF,;THE TOWN CLERK S.FFOLA- '- iTown of Southold - � �OG� Application No. /5.- Judith T. Terry, Town Clerk r y Town Hall, 53095 Main Road .0 7 $10.00 - Residential P. O. Box 1179 `� :- . $25.00 - Non-Residential Southold, New York 11971 Ort 3' == *.$ Telephone0 • (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for . _ - OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ • DATE j 'OWNER NAME: a„., OWNER MAILING ADDRESS: a�� iD -�Q'9 ( ,',9/ OWNER PROPERTY ADDRESS: cSoz/7//C � // 77 OWNER TELEPHONE NUMBER: TAX MAP NO. : Section .7 C0 Block 3 Lot 6.03 CROSS STREET: .449K Oil7/$ , �/ TYPE OF SYSTEM: Septic Tank New � Existing Cesspool New � 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 ' r RECEIVED BY: Town Clerk's Office DATE: / -/lobo I CARL P. & MARY C. BOERGESSON c 1 , - (DWELLING) , - . A. ! NOKOMIS ROAD i . ' . - " . i • Q n SURVEY OF • PRP. & MT Y . r • A T SOUTHOLD • . TOWN OF SOUTHOLD • . , Hr S. REF NO. 90 - SO - 47 SUFFOLK COUNTY, N. Y. 1000 - 73 - 03 - 42.3 • Prepared in accordance with the minimum Scale 1�� = 20� : standards for title surveys as established , by the L.LA.L.S and approved and adopted April 4, 1990 . for such use by The New York State Land , ' Title Association. t Sept. 28, 1990(found. loc.) Dec. 4, 1990 (fine/) , _ - . CERTIFIED TO : - NORSTAR BANK - • • - TICOR TITLE GUARANTEE COMPANY s © PETER R. BRANSFIELD ' �5� .11.-7/0 SG ,, - AREA = 13•,090 sq ft u� aW� • r • - 44,'r' '. K' ,• .r.s. LIC. NO. 49618 - ' - - S a� g SU-VE •. -A P.C. , - , - . , ' �.t r c . ..,, p . _,0, • .', ' ` SOUTHOLD, N.Y. 11971, ' '= ., .,; , , _°=, - :;"'k ik,"•,'-'-'�..., {, _.•F{="r`-;--,,— . , 'i a_ ,y i, - ,yr',�,.2. -•,1"-i;.ay.k1' '''lN-i'•'"r„‘'14,•Vii_' r'' ;1 t S, ,i>� ,,I1' - ,N, -ala„f:•T•:,Y"..1",. ,R: .i�. ,>1.; �,r:;,&,.r� i',11.�1.�,. +, d `r';.S.i;;A�$,.4��.1•;,...*:- • •u' i<yl,' • .'5, net= _ ,-,:' ,..g ."^1°.:•t( ' ''‘''.: f:!'r"`�41,-"1;,<:'. �.t- ..:;l$$'" k.f .ta`r� gI ,at, - ,yti �e;2i°•"--• - i ;. .(��`i�!c-'`}�:s` _?!+At�'+�:-�' -� , ,i , ''�4�- gypp .r:a e�. i .c.,�,t 4�,,:. �i�H•,`�Je a_ �'� '`""� �'• ,. ,�. d - .., q ,,7,-,1,,,,,,,,,,-,,..f 7,- 1,,,, �,�'" §,,1,5-,, ism.,^r ,:„-';` ,-,-4:,-,+•.,__• �� , -- �. 9. .,ir'•.c�� ,'j ;1i' ;,�' ''',r e�,• y".�+rt'�•,'r``�t�..w.oafa ''Y; A� 7 ,•ta,. ^+ : .a.:...�. _.._�.'Ea,� .�, • r-'L'e�.pwx.a... 3p':"�, i i {y� 1`6ii" 'b"�O �I 4 1,l ,..,.., 4-,,,,,,,,,,, e . I, ' . ----211m.- . ril _ N/OIF ao o WILLIAM H. BURKHARDT y O • ® tA R1 Rs \i . gi p O \ pp.q wet el ,1 �i a 119.00' o 10 FEN�E I►_� ` N 02' 09' 00" W 4 At it RE le 4fC EVERGREEN HEDGE I (-4 . • 0 ' - a 1111 11 °1 (71 • 19.4'I • -1 - 1 = ro i v . c i � � 1 7.0' _ 20.1_ _ 1 1 i m "C liaoC�o.N. e' o 14.0' ' O C r. _ — — IN' -ciii I r Obn O y 4.......: V) Mai • I ;Ik 23 • COVERED-.4 PORCH IV• irlOI a I " a—o i . m ca a. I It st 44 -et e1 I - `I aaoo IgE _AReo * < _ I I Pi ' Q I ci 4 CO Q3 ' I I S 02' 09' 00" E io , • 119.00' EDGE OF ASPHALT . HIA WA THA 'S PATH , - ,• _ . a �� d; .