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HomeMy WebLinkAboutDean (2) OFFICE OF THE TOWN CLERK , Fk Town of Southold c31 A' Judith T. Terry, Town Clerkkt s•:.,,1 Town Hall, 53095 Main Road - r= P. 0. Box 1179 C cn '"``4 k"�{ Southold, New York 11971 TelephoneyQ( '11:. • (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 127 Residential X Fee $ 10.00 Non-Residential Septic Cesspool x NAME OF OWNER: Robert F. Dean OWNER MAILING ADDRESS: Box 93, RD 1, Deep Hole Drive Mattituck, New York 11952 OWNER PROPERTY ADDRESS: Deep Hole Drive Mattituck, New York OWNER TELEPHONE NUMBER: 516-298-4525 TAX MAP NO. : Section 115 Block 14 Lot 14 CROSS STREET: Richard Street TYPE OF SYSTEM: Septic Tank New Existing Cesspool x New Existing x Residential x Non-Residential DATE OF PREVIOUS PUMP-OUT: None 404:447`". •-•'4 L'"/"4"24-"""' Judith T. Te Southold Town Clerk DATE: November 6, 1986 (TOWN SEAL) OFFICE OF THE TOWN CLERK S�FFD( rCQ Town of Southold OHO G' , Application No. /2 7 Judith T. Terry, Town Clerk �,rzs- `\ Town Hall, 53095 Main Road c } ! Residential P. O. Box 1179 � � . �.` Non-Residential Southold, New York 11971 Telephone -.776:14 °• " (516) 765-1801 TOWN OF SOUTHOLD trtlIVRi ®� ®� � � SOUTHOLD WASTEWATER DISPOSAL DISTRICT /ow ©( APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. ,02/7 Fee $ C) . DATE , S ' VC OWNER NAME: J $'v-RC1 4fLeitv, OWNER MAILING ADDRESS: ; ct3 ( ( 8 --Qo 4s /�' OWNER PROPERTY ADDRESS: )^Y£ C/) c J terS OWNER TELEPHONE NUMBER: 09 — ij5 05 TAX MAP NO. : Section /M.-- Block /7- Lot ,/ /- CROSS STREET: TYPE OF SYSTEM: Septic Tank New Existing Cesspool New Existing Residential X. Non-Residential DATE OF PREVIOUS PUMP-OUT: 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.) 0 0 0 I A 06/at:- Signature of Applicant , RECEIVED BYir Town Clerk's COffice DATE: �R��tiiu..�� /7'31/i- c rUU(kr ‘470 1 • fir. ' ' - "fA Town Hall, 53095 Main Road-_ � ,�' P.O. Box 728 cry Southold, New York 11971 JUDITH T TERRY TELEPHONE TOWN CLERK (516)765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD August 8, 1986 115-14-14 Robert Dean Deephole Drive Mattituck, NY11952 Our records show 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. 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. I have enclosed an Application for an Operation Permit. Please complete the Application and return it to this office along with the proper fee. Enclosed you will also find an Informational Bulletin regarding the Southold Town Scavenger Waste Treatment Facility. I hope this will aid you in understanding the Scavenger Wastes Ordinance. Should you need any assistance or have any questions, please do not hesitate to contact this office. Very truly yours, Judith T. Terry Southold Town Clerk • Enclosures (2) JTT/Ijc