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Home My WebLink AboutHealion CV JUDITH T. TERRY : Town Hall, 53095 Main Road TOWN CLERK : ® '_ P.O. Box 1179 Southold, New York 11971 REGISTRAR OF VITAL STATISTICS Fax (516) 765-1823 MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER e •0)pt Telephone (516) 765 1801 FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 3288-R Residential X Non-Residential Fee $ 10.00 New X Existing Name Of Owner HEALION, MICHAEL J. Mailing Address 1 29 DALE LANE Mailing Address 2 City St Zip SMITHTOWN NY 11787-0000 Property Address 1 370 SOUTHVIEW DRIVE Property Address 2 City St Zip ORIENT NY 11957-0000 Owner Telephone No. 516-323-2305 Tax Map No. section 13.00 block 1 lot 9.000 Cross Street BROWNS HILL ROAD Issue Date: 12/07/94 Judith T. Terry Southold Town Clerk (TOWN SEAL) OFFICE OF THE TOWN CLERK ' c�VFFOUr • Town of Southold Q ,.. C'� Application No. • �s�S Judith T. Terry, Town "Clerk' �' Town Hall, 53095 Main Road A. :c $10.00 - Residential p. O. Box 1179 cn 1t0 ' i • $25.00 - Non-Residential Southold, New York 11971 Q.`® a!*1:' e,`, Telephone of '' (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ • DATE / 2102/ g2/ OWNER NAME: /7)eA19e L T T. /Jt'1' OWNER MAILING ADDRESS: / /1J //7t7 OWNER PROPERTY ADDRESS: .3 70 Som 7-A ,`"D,c OWNER TELEPHONE NUMBER: 3 2 3 - 367,..r" TAX MAP NO. : Section 6 / 3 Block / Lot 09 �CROSS STREET: eocti �� ,�L L „Q0- TYPE OF SYSTEM: Septic Tank 10 New k" Existing Cesspool F/ New 1V Existing Residential t, Non-Residential DATE OF PREVIOUS PUMP-OUT: 0 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.) freia," 1 6( / Signature/ Applicant RECEIVED BY: Town Clerk's-Office DATE: / —6 --99,( , t,,45:.3,4 5,.•i r C.-", ,.. t j„ ; i ___ 1 .... -1,. , . -'4‘11,u . ,,,, - , -. ; .,. 1./�Yw►f'w� P.T�7N��--. �. �.V.�., ,j �.h 1 ! �� 1�P«J is... '\``* 0. 1 a.LVAfat).' "_ ;:i.A! fCI it -__ _' _ -�_ "e "A.:.,1 11 `-/S- ---�__ (321 "1-11H SNN\MC3 Q.l. f'I'902 " • 0S''" 1 f_�'4°7 > • ,' f� U..)- - . , . (..) % r . , �o .., " . , - . ' ,1 ' 'gib ` 1 • ( .~ra 1 1 sad) , , • , . 1' ' ' it; ,.., 1'-)1 , , ,11 - __ .. , ,. ., I 3 4"10047 ;�J'!- ;�jb� I 0 __ 1 b •'-- . • : rri „, �, m, 10. to •, .A • -, r } LZ SC . < 1 asriori sw're.i I . . t \ R .121015 -i' ' \ ,t . , -1-_ m(AJ .„ • Ilii ,u ► • W1s ‘ 1 a4 -Z ,: Cc, fir\• , Oji t ,�� ' .,, � ` fQ cis '� , %..... ..„---, -*-- .s6 .,,, -. ...._ `.. ..„,?, %,—..:::, 'A rie'• P, , , ,,, i'l 1'1 ,,. .L3-"P cl- .,, -- :‘,...."., ,. ,:-.(-- -4-Nily ' ,, -z,, .„,,, „.„ em....., : ,. - ---•„, ii,/ C"()WI ----. .'-'-'''-- - c -- �, .:_. Po ----.--,.. , 'S 3\ii--01 A . 8ii _.._,...,... 2: 6/L� ''1��,n -3 ^awe 1 ;13,Z1 '