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HomeMy WebLinkAboutDaly (2) 4Leir OW PSIS 41® Town Hall, 53095 Main Road JUDITH T. TERRY , TOWN CLERK ® �� P.O. Box 1179 REGISTRAR OF VITAL STATISTICS `. ��' Southold, New York 11971 MARRIAGE OFFICER 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. 1906-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New Existing X Name Of Owner DALY, ROSELYNE M. Mailing Address 1 205 KNAPP PLACE Mailing Address 2 City St Zip GREENPORT NY 11944-0000 Property Address 1 205 KNAPP PLACE Property Address 2 City St Zip GREENPORT NY 11944-0000 Owner Telephone No. 516-477-0246 Tax Map No. section 34.00 block 3 lot 13.000 Cross Street BAILEY AVENUE Date Of Last Pump Out 0/00/00 Issue Date: 5/19/92 Judith T. Terry Southold Town Clerk (TOWN SEAL) ' OPERATION PERMIT ' - SEPTIC TANK or CESSPOOL , ' ' Operation Per•mit, •No. !�l®6 = , : Fee $ GO ' ' . , t• . am ` qtr , - - . � ',a,• / ,-9. �DATEJ, C9 - ,. •, OWNER NAME: 6. 0 , 1;-- 4 y i\( I--- 144 . 1'9— , y , , :'. „ -..•....,---",,,:f',..,E."',-.•c• : ' • OWNER MAILING ADDRESS: �Jci_ ?'-`'' i O1NN E R-P -/4 tTB R 9• ;_, : :a.�. ;:- >-,",-.r,,,,::%'.;1< i R6PERT `' ESS: _ _ � :'.;,.,,:.,;Y,. ; r :' `~;;',._::, OWNER TELEPHONE NUMBER: i 6 - ,,:,,,, TAX MAP NO _ , >, '-,..••,,54.. ,,,,44,•:'!;;‘,':,,4-.' 5 Section 3 Block3 , - - � m",--2.,:-''•` ,,;, Lot / 3 L r -7.' -� .s`::y` :,, :` OSS STREET. �� 1 , "�• , ,.,;' ,.:'-'-'1.:,.',.',,�,, :,o= z:;,• .1 - .� }'~;.rt ^fir--y r�•v- ' TYPE `OF'SYSTEM. Septic 'Tank . _ y ,'�'', , l .-vrr; New Existing :,41 xa_ -;,•:,,*,„,r,, gl fi Cess pool New Existin• g Residential / Non-Residential ` -• '; - DATE OF PREVIOUS`'PUMP-OUT: LOCATION MAP: Must be attached hereto before permit may be issued. = `- r�=• f'” '_.:� f -:(Locate building and system; give north arrow and feet ,.:,_ _ , ,; `--. ..!„_.....1._____,_,______ .. .. ofdistance approximately„ tobuil-din aid' closest4 road,)_ �r , r ,} ; . „ ;, 4a °;Y::'r , _ ,:,;•* ., , y •1r ; ,' : •:; :St!' ..t s �y:ii,iX4 `+ .�`�?,,.r n~ ^+c,• ,F ,, �,,ny-r • . ' ,;.t.J+ �,ah,,:.-�s> 1c^, i `".M:y�;: v; r, ..-- 1i „v, ,,•, • ,signature of Applicant RECEIVED BY': Ai- _ . ”, , ' ` Town Clerk's Office , , ...,_ • DATE.{ ' ,ji �— ,•• :: • ;;r::,: cr (-3 , clo 13( ,..p 7 rIr a-Q-5 ;‘..• JUDITH T. TERRY J1 Town Hall, 53095 Main Road TOWN CLERK 7 } ;; �_.�, j P.O. Box 1179 REGISTRAR OF VITAL STATISTICS ,-: s;' " Southold, New York 11971 MARRIAGE OFFICER ,'-) 1 , Fax (516) 765-1823 Telephone (516) 765-1801 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD December 5, 1991 Roselyne Daly 205 Knapp Place Greenport, New York 11944 Re: 34-3-13 11-91 Dear Ms. Daly: Our records indicate that you recently had your cesspool/septic tank system pumped out. According to the Southold Town Scavenger Wastes Ordinance, any owner of an operating, on-site sewage disposal system, such as a septic tank or cesspool, must obtain an Operation Permit for that system. The Operation Permit is issued by the Southold Town Clerk's Office. The fee is ten dollars ($10.00) for a residential system, twenty-five dollars ($25.00) for a non-residential system. You will not be asked to obtain an Operation Permit each time you have work done on the system. The permit is only issued once for each system. Enclosed is an application for an Operation Permit. Please complete the application and return it to this office along with the location map and proper fee. (NOTE: The location map may be a copy of your survey with the location of the cesspool(s) indicated or a sketch of your property showing the location of the buildings, cesspool system, and approximate distance in feet to buildings and closest road.) Also included is an Informational Bulletin regarding the Southold Town Scavenger Waste Treatment Facility. I hope this will aid you in understanding the Scavenger Wastes Ordinance. Please do not ignore this request. Should you have any questions or need any assistance with the application, please do not hesitate to contact this office. We will be happy to assist you in any way we possibly can. Very truly yours, • • Judith T. Terry Southold Town Clerk Enclosures (2) - ljc