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JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS
tri `� Southold, New York 11971
MARRIAGE OFFICER ®A`®1 ®0 yet Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER '�l 0..� Telephone (516) 765-1801
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3211-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner DEALE, MARGARET T.
Mailing Address 1 33 SUNSET LANE
Mailing Address 2
City St Zip GREENPORT NY 11944-0000
Property Address 1 33 SUNSET LANE
Property Address 2
City St Zip GREENPORT NY 11944-0000
Owner Telephone No. 516-477-0351
Tax Map No. section 33.00 block 4 lot 48.000
Cross Street SUTTON PLACE
Issue Date: 5/26/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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QFFI'CE OF THE TOWN' " CLERK •��FFU
Town of Southold NQS CQ ' S Application No. `/
Judith T. Terry, Town Clerk � 4=4� < +� $10.00 - Residential
Town Hall, 53095 Main Road
P. O. Box 1179 crs " $25.00 - Non-Residential
Southold, New York 11971
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION t"
for --- - -------v-------- - - --.- - -
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ f '
DATE 5 /( /q6/21
OWNER NAME: 10aPgcleezi -7)ee
OWNER MAILING ADDRESS: 33 6a05et hi
- .flWNER PROPERTY ADDRESS: sadri z?
OWNER TELEPHONE NUMBER: 5/4 — /71.79-635-
TAX
79 -o35TAX MAP NO. : Section 3r-b . Block Lot vei
CROSS STREET:
TYPE OF SYSTEM: - Septic Tank ' - -New Existing
Cesspool'st, New Existing
Residential Non-Residential-
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.)
(1
ignature of Applicant
%'RECEIVED BY:
Town Clerk's Office
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DATE:
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JUDITH T. TERRY "f„Ya Town Hall, 53095 Main Road
TOWN CLERK nw P.O. Box 1179
”� K ` Southold, New York 11971
REGISTRAR OF VITAL STATISTICS It' .r �t Fax (516) 765-1823
MARRIAGE OFFICER " `F � �� Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER n �.
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
May 5, 1994
Margaret Deale
135 Sunset Lane
Greenport, New York 11944
Re: 34-5-11 4/18/94
Dear Ms. Deale:
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)
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