HomeMy WebLinkAboutDrumm 000110,41
B. vs Town Hall, 53095 Main Road
v® Ni" �,' P.O. Box 1179
®1 ®r 'fiSouthold, New York 11971
JUDITH T.TERRY
--'-',,,,,,,,,,s0
',,,,,,,,, 0zig 1% TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 711-R Residential X Non-Residential
Fee $ 10. 00 Septic Cesspool X
New Existing X
Name Of Owner DRUMM, EDWARD A.
Mailing Address 1 P.O. BOX 46
Mailing Address 2 PEQUASH AVENUE
City St Zip CUTCHOGUE NY 11935-0000
Property Address 1 PEQUASH AVENUE
Property Address 2
City St Zip CUTCHOGUE NY 11935-0000
Owner Telephone No. 516-734-5113
Tax Map No. section 103 . 00 block 7 lot 19.000
Cross Street WILLOW STREET
Date Of Last Pump Out 4/00/72
Issue Date: 5/23/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
.. „„.45.
OFFICE OF THE TOWN CLERK cOFO(,r
Town of Southold �� .. CQG' , Application No6.,"?"/
Judith T. Terry, Town Clerk , ;:
Town. Hall, 53095 Main Road 4. ' ''�'" '' Residential
Uzt k
P. O. Box 1179 7 ��r 1
�� Non-Residential
Southold, New York 11971 O:7_°/ ,1*Y AOS ���
Telephone �
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
- - .--- for - - -
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $16 '
DATE 3/er
OWNER NAME:1IL 10
��Jd 4- 4 ,
•
OWNER MAILING ADDRESS:#gL / /12 4,f-a
.c_40- //9,-r4—
_ OWNER PROPERTY ADDRESS: _ _ 4 '-
/
OWNER TELEPHONE NUMBER: 7d I, '// 3
TAX MAP NO. : Section /0,3 Block l Lot `F
CROSS STREET: 0.) ow S7 Ja,
TYPE OF SYSTEM: Septic Tank I/ New Existing V
Cesspool V7 New Existing 1"
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: Arige;e / 97o
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.)
y&II/09-;61,-11/4-424744,--'
Signa ure of pplicant
licant
RECEIVED BYE 5Z,'LVc.,--,_ " s
24-(
Town CI ,rik'sr Offic
DATE: / 3 I�U`
V • •V•..
i g dwA r&J
A-1-)------1'
1
'1
...__.
______________________. __
_____
/ ,
t__.., ..... • ,__.....„ , A, _____.
_ , _ _._
_ _______ .____ _ ._. ___. ___ _
z _ _
__
, .
_ ..__ _
. _ ______.-
rl
-I' 0----":":" :--
k
_ _ I±,1
_
1.
_-_____P Dr4 _. . _. . _ _______ _
r
1