HomeMy WebLinkAboutBochner SCUrF CLD VIASTEVIATER Ol SPOSAL PERM T
CPERATI CN PERM T
SEPTI C TANG or CESSPOOL
Cper at i on Per rri t W. 4455-R FResi dent i al X Nbn-Plesi dent i al
Fee $ 10. 00 Naw X Exi st i ng
Terre Cf Ower LI ZBEM MV*M MEL BOCFNER
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Nbi I i ng Address 1 108 FRAWLI N STREET'
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Nbi I i ng Address 2
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a t y St Zip NEW YCW NY 10013-0000
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Pr oper t y Address 1 12455 NAI N BAYM EVVRD
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Property
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Property Address 2
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0 t y St Zi p SCUTI-ICLD NY 11971-0000
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Gooier Tel ephone W. 917-912-6838
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Tax M6p W. sect i on 88. 00 block 1 1 of 12. 000
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Cr oss St r eet M OLAND PARKVIAY
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I ssue Date: 6/26/ 13 EI i zabet h A Nevi I I e
-------- Sout hol d Town 0 erk
(TOM SEAL)
` �osuFFot�-�o
O p
ELIZABETH A.NEVILLE co y� Town Hall, 53095 Main Road
TOWN CLERK W 2 P.O. Box 1179
REGISTRAR OF VITAL STATISTICS O Southold, New York 11971
MARRIAGE OFFICERy • O!� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER l `1►a Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
OPERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @$10-1—or Non-Residential @ $25 Application No. ��
Permit No.
Owner Name OAafromo -. o Y
Owner Mailing Address t d g Fr A V\ K(`,`SYN S fi
my C
Owner Property Address IOW 5 5 M06 ---\.kj
Sia C ( d , my I1q � 1
Owner Telephone No. 9 1 ? '-6 S 3 �-
Tax Map No: Section Block Lot 1
Cross Street M1 ave po'Y- wc�j
Please check each that applies: New Construction X
Alteration to Existing System
Residential. X 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 submit copy of survey with SCHD approval.)
I M
Signa a of Applicant Date
Received by:
I
SURVEY OF PROPERTY - —x— 867°469000p
51TUA�TE: SOUTHOLD N x—x—xI�
TOWN: 5OUTHOLD
SUFFOLK COUNTY, NY LQ 14p"�p4ne
x
C x
��'olgr
SURVEYED: 08-14-2001 Reese �y op; Y� f::RAME
5EPTIG ADDED, SURVEY NOT `
UPDATED IN FIELD 01-20-2011 - _ S67-46-00 ry RRA/STORY •.9 x 0 SSLA8
HD 02-15-2012, 0-7-20-2012 _ „ x '�i CJ ory s APA N s
���,
11-15-2012, 11-2-7-2012, 12-26-2012 / 4.'.. s, SAB 5.,,
06-01-2013, O6-IQ-2013 5T "� � moo"`' 2 °ro
u, o, x�
SUFFOLK GOUNTY TAX # % - - - �s . - e a '�'�, _` 73' sl Y2
1000 - 88 - I - 12 srq� ON "
C ERWIED TO: o / ON �aee °
�N / �wopa� e+a Y eg�CRr g �rovel
MIS.BOCHNER r' / �1 �. civ WQy s a
LIZ BETH MARANO a sF / ✓ �`�,� s
w
F9R5'r AMMCAIeT T=
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pN
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FOLK COUNT- f-f ll- j1-I DEPT.
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00
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urzwu-ossa atteratwn or aaanion to a w,.ry
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a2otaz,oln
StdE-dLm-
VQC�It Y <p♦��' ' stnQ»eJn chapiee tfroomwgtlrowaoerriwc'tox d th-
NOTES: °13.20 yialrtve�y
'CertNcdbro iWicdea rlereon ag�ry tMt tnc
eur.ey.ne prepaea n occaaa�ce nnn tk ex-
MONUMENT FOUND eL sera r—teaw�V�twu y
. the New Yak state Nsxkibn or WdeaSipictl
to the person[a w+an tts e1"4 re
c ppared,
as m w tx[ar to the to eonpuy,
w aegererceynmoevierencar.eg wraie[xteotloonaamrttloeaaagnl ew�reelarttutim
to1000 6ALLON SEPTIG TANK 8DIA. 12' DEEP GP's -'a-,
t
AREAa-
AREA = 166,128 5.F. OR 3.8138 AGRE5 JOHN
ae-
C. EHLERS LAND SURVEYOR
6RAPHIG SCALE 1"= 60 6 EAST MAIN STREET N.Y.S.LIC.NO.50202
RIVERHEAD,N.Y. 11901 369-8288 Fax 369-8287
REF.-C:\Users\lohn\Dropbox\07\07W7-194.pro -
N:.
111
5URY LY OF PR0PERT'r \x�x_x_8 90
�s 46900F,GP "_k
51TUATE: 5MTHOLD _
N \
TOWN: 5MTHOLDa pro k x
pQne 0 kik\k\
5(JFFOLK COUNTY, NY L 4rjc �„,
moo!Reese rly of
5EPTIIG EADDED,D. (SURVEY NOT �" ,t w �, c QED
UPDATED IN FIELD 01-20-2011 S6 °
n STOGY 9 x Oh SLAB
46, NJEF
HD 02-15-2012, 0-7-20-2012u4 'G; 7 00"a S ON
SAB
11-15-2012, 11-2-7-2012, 12-2b-2012 _ ,�Y I
06-01-2013, 06-Ici-2013 / � :'_. 5r xqr t— 3, ry GFIR -_ =
SUFFOLK GOUNTY TAX # ¢ � sTe _
1000 - 88 - I - 12 / "'P , 73'
ON
C.)ERTEF D'B ID: o
ON�^e�� jravel
AOL BOCHNM
v
a
LIZ BETH MARAN® o II w / � � x_t�"� s pm POOL
FIRSTAhIMCAN o�u �'
Y19
FOLK GOON H >4H DEPT. DETAIL
. NO. RIO 2)4! / / j
I"= 4-O'
o o / - I
wtv
a -
a V W � 1 j
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o - _ It
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h�{� _ a
Ali
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® `• gAl-i,.
�\. O � it,o„trnri:se orterdw,a aaatim to o w.rey
atp txarxg o iice.eea baa a�`cy°f"'xai'm a
�, btu,d aectioa Ozal,xaa�dwn z.d the i
`` tie..Yak 5[Me Eecdion Lan' '
4 L "rl coAhm Tram gthe - . d ltW evvey
vQCQ(tL a /v ' M—P..—,—,I b i.Pni0 t`(y'�_yo--1.t— iI
a Y�°y3, \ topics•
NOTES: l 2(D"grgr V 'Cartrratiore nekctea nereaagMy trot lne
xy ae p spam r arta m e.nn t K e.-
ia/vy GMe d P'actKe Far LorH Srveys aaoptetl
MONUMENT FOUNDto tna
Lane tJRveya'9.5ald txttlk:dbrb Snap iiti
mO on laa befglf to the Ittb toepony 9overmeer
td oyercy bd IMd'rg MliWtion IialeG tgroon,oi0
1000 GALLON 5EPTIG TANK 8' DIA. 12' DEEP GP'sa the d as nrt a `e`"ra-
7�� tt�,a are not tro�rerawe to maitronoi�natnuiona
AREA = 166,1285.F. OR 3.8138 AGRE5 JOH C. EHLERS LAND SURVEYOR
6RAPHIG 5GALE 111= 60' 6 EAST MAIN STREET N.Y.S.LIC.NO.50202
RIVERH1EAD,N.Y. 11901 369-8288 Fax 369-8287
REF.—C:\UsersVohn\Dropbox\07\07\07-194.pm
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