HomeMy WebLinkAboutMoglia r M
OF SO!/r
ELa A.NEVUAZ,1EiMC,CMCti,4, Town Hall,53095 Main Road
T*WN CLERK , P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold,New York 11971
MARRIAGE OFFICER Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER ,�►/ Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUI'IiOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4390-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner JOHN MOGLIA
------------------------------
Mailing Address 1 10 POPLAR STREET
------------------------------
Mailing Address 2
City St Zip SAYVILLE NY 11782-0000
Property Address 1 1380 KOKE DRIVE
------------------------------
Property Address 2
------------------------------
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 631-872-9618
------------
Tax Map No. section 87.00 block 5 lot 18.000
Cross Street MAIN BAYVIEW ROAD
------------------------------
----------------------------------
Issue Date: 3/04/09 Elizabeth A. Neville
-------- Southold Town Clerk
(TOWN SEAL)
• �OSOF&I
ELIZABETH A.NEVILLE �`t`� �G.y Town Hall, 53095 Main Road
TOWN CLERK p P.O. Box 1179
W Z Southold, New York 11971
REGISTRAR.OF VITAL STATISTICS V.
MARRIAGE OFFICER Oy �.F Fax(631) 765-6145
RECORDS MANAGEMENT OFFICERTelephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER �'� �a southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
OPERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @ $1W or Non-Residential @ $25 Application No. /
Permit No. 367 m.
3,571
Owner Name J o N 11
Owner Mailing Address
1'
Owner Property Address
Owner Telephone No.
Tax Map No: Section Block W Lot
Cross Street
Please check each that applies: New Construction
Alteration to Exis ng System
Residential Non-Residential
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. (Locate
building and system; give north arrow and approximate distance in feet from system to building
and closest road. New construction may sub 't copy o urve with SCHD approval.)
./-o 9
00 SignatuKof Applican Date
Received by:
SURVEY OF PROPERTY
V SITUATED AT
BAYVIEW
wq y �rJ TOWN OF SOUTHOLD
' /" T/� SUFFOLK COUNTY, NEW YORK
3 v S.C. TAX No. 1000-87-05-18
s SCALE 1"=30'
Jerry oo� APRIL 10, 2006 I
h�• Ory JUNE 6, 2006 ADDED WELL LOCATION
MARCH 9, 2007 ADDED PROPOSED HOUSE
JULY 11, 2007 FOUNDATION LOCATION
/ y OCTOBER 30, 2007 FINAL SURVEY
NOVEMBER 30, 2007 ADDED SEPTIC SYSTEM LOCATION
S640 AREA = 12.80.00 c. ft.
10
103
o/ ST';;
16 /
' •• • �� 7s. 40J�0
CV
CIV
O h 2
WW
w o v�r
ca
�. gyp"` N
�y �� / ��vJ
./ ACCORDAHM THE MIND"
oRl1}�, ^^ 3 �q G��p"o2 "TSR TIRE MD APPROVED S E3T
'Y ;�Rl�,� - '•o N'�•9Y O ADOWED
O w 2 J p� - �F£NEW YORK STATE LAND
64 _. .. s/ G
qn,� cp o fm f r
h'p r/� � " - tib / � ,� `�'• "�
N
10 �� J
Op. / N.Y.S. Lie. No. 50467
UNWHORM ALTERATION OR ADDITION
TO THIS SURVEY 5 A VIOLATION OF
SECTION 7209 OF THE NEW YORK STATE �'3 Y' ■
EDUCATION LM. Nat aft Corwin III
7' - - - - '' COM OF TINS SURVEY YAP NOT OE406
71 IN=Wr E CDR Land Surveyor
NOABOSSm SEAL SNW.IDI'.BE CON'NOERm
10 EE A VALD TRUE COPY.
CIOTRFICATIONS INDICATED MWON SHALL RUN
ONLY TO 7FE PERSON FOR WFIOM 71 SURVEY
. IS PREPARED.AND ON HIS BDRMF TO THE -
M E COMPANY,GOVERNMENTAL.A(XNCY AND rft Sunmgs —Subdivisions — Sft Plods — Cons6Nrction U"a
LENDING NSITRRION USTED NNQEON,AND
TO THE AS90IEFS OF 1HE UENDNG NSR-
nRION.COMFICATIONS ARE NOT TRANSFERABLE. PHONE (631)727-2090 Fox (631)727-1727
THE E705TERM OF RIOW OF WAYS OFF LOCATD AT 1/I&M ADDRESS
AND/OR EASEMENTS OF RECORD, IF
ANY, NOT SHOWN ARE NOT GUARANTEED. 322 ROANOKE AVENUE P.O. Box 1931
RNQtHEAD, New York 11901 Riverhead, New York 11901-0965
II
i
i