HomeMy WebLinkAboutConnolly, John ',���,
ELIZABETH A. NEVILLE � = y1 Town Hall, 53095 Main Road
TOWN CLERK ; y P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER ,. y,L
40.
RECORDS
Fax (631) 765-6145
RECORDS MANAGEMENT OFFICER � '/Ol jilt %/4'0.1i Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER .40•1
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4053-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner CONNOLLY, JOHN
Mailing Address 1 PO BOX 1021
Mailing Address 2
City St Zip CUTCHOGUE NY 11935-0000
Property Address 1 1496 SKUNK LANE
Property Address 2
City St Zip CUTCHOGUE NY 11935-0000
Owner Telephone No. 631-7311-7312
Tax Map No. section 97.00 block 3 lot 11 .009
Cross Street EUGENE ROAD
Issue Date: 10/16/00 zabeth A. Ne ille
Southold Town Clerk
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK C�F FOte --
TOWN OF SOUTHOLD 1� �O Application No. qC
s.,
ELIZABETH A.NEVILLE,TOWN CLERK $10.00 - Residential `f
P.O.BOX 1179
Lr3
SOUTHOLD,NEW YORK 11971 � $25.00 - Non-Residential
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Telephone �j * 0''�•
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
RECEIVED
for
OCT 1 2
OPERATION PERMIT
Suvtneid i own Jerk
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE ) 0 " R .0 • 00
OWNER NAME: ( h � CO hV ' /
OWNER MAILING ADDRESS: . IOa k
.3kko5vt_ ) (v_L-k C15
OWNER PROPERTY ADDRESS: 149 Cp 0. •
QJ4-0,\ oau c) 1V L`• Rtt 3S
OWNER TELEPHONE NUMBER: (pt - 13y
TAX MAP NO. : Section Q1 Block CO 3 Lot 1 t .
CROSS STREET:
TYPE OF SYSTEM: Septic Tank v New V Existing
Cesspool 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.)
Signat re o Applica,
RECEIVED BY:
Town Clerk's Office
DATE: 0 • 00
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POST
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1 a NA SUFFOLK COUNTY, NEW YORI
- -_-_---_-_---_- S.C. TAX No. 1000-97-03-11.'
/ SCALE 1"=40•
MAY 21, 1999
JUNE 7. 1999 ADDED PROPOSED HOUSE I
DECEMBER 9. 1999 UNDER CONSTRUCTION SUR\
1.,1 SEPTEMBER 15.2000 FINAL SURVEY
AREA=17,129.44 p.N.
4144 2.000 ov.
0 £
IIA WS J. MOTT
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tlaity O. 11017
FULITY NATIONAL TIRE INSURANCE COMPANY OF HER
JOHN P.CONNOLLY
OS.C.O.H.S. REFERENCE No. R10-99-0118
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