HomeMy WebLinkAboutMeyer, John ,
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ELIZABETH A. NEVILLE d= t: Town Hall, 53095 Main Road
TOWN CLERK ; y P.O. Box 1179
REGISTRAR OF VITAL STATISTICS k Southold, New York 11971
MARRIAGE OFFICER `� �fi l��1�, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER = �! 4:00.� Fax
(631) 765-1800
FREEDOM OF INFORMATION OFFICER ,�I
OFFICE OF THE TOWN CLERK
SOUTHOLD VCASICIDEEOIROSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4076-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner MEYER, JOHN & GAIL
Mailing Address 1 44632 MAIN ROAD
Mailing Address 2
City St Zip SOUTHOLD NY 11971-0000
Property Address 1 44632 MAIN ROAD
Property Address 2
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 631-765-1397
Tax Map No. section 75.00 block 6 lot 7.002
Cross Street PECONIC LANE
Issue Date: 4/16/01 izabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK cOFQ(,(`;'
TOWN OF SOUTHOLD OG= Application No.tfl
ELIZABETH A.NEVILLE,TOWN CLERK 4 $10.00 - Residential (�
P.O.BOX 1179 LI"
SOUTI1OLD,NEW YORK 11971 *.$ $25.00 - Non-Residential
Telephone 0j * sp9:0
4.
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(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
APR 1 1 gg01
OPERATION PERMIT
AuurnQIU town chprk
SEPTIC TANK or CESSPOOL
oq
Operation Permit No. �I
Fee $,),
DATE O 6 c26-6
OWNER NAME: jE)(r) 1114-' CK._
OWNER MAILING ADDRESS: 1F 3L ()lain
1 /1/
S r)1 '1O l // S7/
OWNER PROPERTY ADDRESS:
OWNER TELEPHONE NUMBER: ( ) / 7(o5 (37
TAX MAP NO. : Section 75 Block ( Lot 72
CROSS STREET: -2c1G (&it
TYPE OF SYSTEM: Septic Tank '/ New ' 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.)
Signature pplicant
RECEIVED BY:
Town Clerk's Office
DATE:
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