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JUDITH T. TERRY % Town Hall, 53095 Main Road
TOWN CLERK P.O.• P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
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MARRIAGE OFFICER •
Fax (516) 765-1823
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(516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3078-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner HARRINGTON, NANCY
Mailing Address 1 550 CARRINGTON ROAD.
Mailing Address 2
City St Zip CUTCHOGUE NY 11935-0000
Property Address 1 550 CARRINGTON ROAD
Property Address 2
City St Zip CUTCHOGUE NY 11935-0000
Owner Telephone No. 516-734-5872
Tax Map No. section 111 .00 block 7 lot 10.000
Cross Street HAYWATERS ROAD
Date Of Last Pump Out 0/00/00
Issue Date: 8/02/93 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK c0FflUr��-
Town of Southold Application No.3Q7 S
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Judith T. Terry, Town Clerk �' y
Town Hall, 53095 Main Road -� $10.00 - Residential k
P. O. Box 1179 a _ :J �` $25.00 - Non-Residential
Southold, New York 11971 O ���
Telephone *ati *6' '
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(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRIVED El
AUG 02 1993
APPLICATION
Southold Town Clerk
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
, Operation Permit No.
Fee $ /O.OD
DATE 4C/4 2, /9 KY
OWNER NAME: Al I/CJ l /(, A I2 ti I I J C T'0 4f
OWNER MAILING ADDRESS: „5",_‹p C,4 wi. /
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OWNER PROPERTY, ADDRESS: S-S'O CA R R. l Ala<<reit)
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C are go 4 ve /sj 1193r
OWNER TELEPHONE NUMBER: (S'/G) 7351. STT
TAX MAP NO. : Section 11 1 Block 7 Lot /0
CROSS STREET: bJ�q/ vm -re Rs 2D
TYPE OF -SYSTEM-: Septic Tank - - New ' Existing
Cesspool )( New Existing ite-
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: Airy R o& t
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.)
Jignature of Applicant
RECEIVED BY: \ - - -
Town CI rk'sOffice
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DATE: ^
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Town Hall, 53095 Main Road
JUDITH T. TERRY y
TOWN CLERK ® Pia P.O. BOX 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER V b® Fax (516) 765-1823
Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
July 8, 1993
Nancy Harrington
550 Carrington Road
Cutchogue, New York 11935
Re: 111-7-10 6-93
Dear Ms. Harrington:
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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