HomeMy WebLinkAboutMcGrath o�og�1FF0�,�-�,
LIZABETH A.NEVIL E Town Hall,53095 Main Road
TOWN CLERK H - P.O.Box 1179
REGISTRAR OF VITAL STATI TICS Southold,New York 11971
MARRIAGE OFFICER 1i �� Fax(631) 765-6145
RECORDS MANAGEMENT OF ICER ®1 ��o Telephone (631) 765-1800
FREEDOM OF INFORMATION FICER southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
S UTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4238-R Residential x Non-Residential
Fee $ 10.00 New x Existing
Name Of Owner MCGRATH, ELIZABETH .�
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Mailing Address 1 1275 NEW SUFFOLK ROAD
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Mailing Address 2
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City St zip CUTHCOGUE NY 11935-0000
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Property Address 1 1275 NEW SUFFOLK ROAD
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Property Address 2
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City St zip CUTCHOGUE NY 11935-0000
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owner Telephone No. 361-734-4046
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Tax Map No. section 109.00 block 7 lot 6.002
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Cross Street MAIN ROAD r
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Issue Date: 1/28/04 Elizabeth A. Neville
--------- Southold Town Clerk
(TOWN SEAL)
I
ELIZABETH A.NEVILLE �`1` y� Town Hall, 53095 Main Road
TOWN CLERK ® P.O. Box 1179
COD 2 Southold, New York 11971
REGISTRAR,OF VITAL STATISTICS W Af
MARRIAGE OFFICER ® Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER Telephone (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 z
CESSPOOL or SEPTIC TANK
Residential @ $10or Non-Residential @ $25 Application No.
Permit No.
Owner Name
Owner Mailing Address l 2-7 !
Owner Property Address -�
Owner Telephone No. 3 4 qy 9
Tax Map No: Section__ncl Block_�_ Lot (0 .
Cross Street
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Please check each that applies: New Construction
Alteration to Existing 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 submit copy of survey with SCHD approval)
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Signature of Applicant Date
Received by:
ELIZABETH MC GRATH
1276 NEW SUFFOLK ROAD
CUTCHOGUE
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1-1 c,
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Town Of Southold
P.O Box 1179
Southold, NY 11971
* * * RECEIPT * * *
Date: 12/30/03 Receipt#: 1016
Transaction(s): Subtotal
1 Septic Permit-Operation - Resid. $10.00
Check#: 1016 Total Paid: $10.00
Name: Mcgrath, Elizabeth
1275 New Suffolk Road
Cutchogue, NY 11935
Clerk ID: LINDAC Internal ID:84921