HomeMy WebLinkAboutHocking 11
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m Town Hall, 53095 Main Road
;� �`� P.O. Box 1179
` ® ' Southold, New York 11971,14,0001
JUDITH T.TERRY � i�� TELEPHONE
rowN CLERK �� o� (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. 785-R Residential X Non-Residential
Fee $ 10. 00 Septic Cesspool X
New Existing X
Name Of Owner HOCKING, WILLIAM J.
Mailing Address 1 552 N SANTA ANNA
Mailing Address 2
City St Zip MESA AZ 85201-0000
Property Address 1 720 N OAKWOOD DRIVE
Property Address 2
City St Zip LAUREL NY 11948-0000
Owner Telephone No. 516-298-9469
Tax Map No. section 127. 00 block 8 lot 5.000
Cross Street PECONIC BAY BLVD
Date Of Last Pump Out 0/00/00
Issue Date: 8/10/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK FD
Town of Southold �� CQ = Application No. 7ff5--
Judith T. Terry, Town Clerk . �+
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Town Hall, 53095 Main Road Residential
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P. 0. Box 1179 cns ` r.` "' '= Non-Residential
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Southold, New York 11971 O
Telephone ®gy� Ntt.°-
(516) . 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
OPERATION PERMIT
SEPTIC, TANK or CESSPOOL
Operation Permit No. 133
Fee $
DATE S ./c))3?5
_
OWNER NAME: 'VD . L . `� ; e
OWNER MAILING ADDRESS: -\S 2 a u .1\
OWNER PROPERTY ,ADDRESS: „Lia
o ,L,f, •1 kC714
OWNER TELEPHONE NUMBER: k-2,9
TAX MAP NO. : Section b —7 Block r---y Lot 41 C
CROSS STREET: Cir 1 UGp
TYPE OF SYSTEM: Septic Tank _- New I Existing
Cesspool New Existing V
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: te)-- 4—
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.)
1 / �. 9�� �'” h1_
Signature if / pplicant
RECEIVED BY:
ortn Clerk's Office
DATE: !1iG°p 1988
Town Cterk Southold
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