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OFFICE OF THE TOWN, CLERKFO -
Town of Southold - ���� ,
Judith T. Terry, Town Clerk •% • •.." ,r
Town Hall, 53095 Main Road
P. O. Box 1179C� `;r- .- •��•
Southold, New York 11971 - Q ` `""'1 -
Telephone
(516) 765-1801 '
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 427 Residential x
Non-Residential '
- Fee $ 10.00
Septic Cesspool X
NAME OF OWNER: Joseph Hollid _
OWNER MAILING ADDRESS: 530 Leeward Drive
Southold, New York 11971
OWNER PROPERTY ADDRESS: 530 Leeward Drive
Southold, New York 11971
OWNER TELEPHONE NUMBER: 516-765-1399
- TAX MAP NO. : Section 79 Block 7 Lot 38.7
CROSS STREET: Jacobs Lane
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New ' Existing x
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: Approx. 1984
�' ► turI1+11 T.- Terry iq
Southold Town Clerk
DATE: September 17, 1987
(TOWN SEAL)
S ....
/OFFICE OF THE TOWN CLERK �c51FO(e .. �"
Town of Southold COG Application No. 2 7\---'
Judith T. Terry, Town Clerk `
Town Hall, 53095 Main Road ' ' x 7 Residential �/
P. O. Box 1179 En A R44Non-Residential
Southold, New York 11971 O � ' - N- .•�`
Telephone -
(516) 765-1801 -
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
. ,v.„r _ - -: • _ - _ _ �_ - :-. -_ _--- ----- -->,,_- -='for -=--_ -. _: - ._ ._ _ ._...�_ _ .. ..�
OPERAT ION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4-A:2-7
Fee $ /O
DATE 9J-/7-?7
OWNER NAME: _ / I--cs-e-&-c/f/
OWNER MAILING DDRESS: �3 6 soo-cam ,Lgc
_S-f,, L-Lo,4e-, l') y y q ?7
OWNER PROPERTY ADDRESS: Min f. __
OWNER TELEPHONE NUMBER: 73 9
j TAX MAP NO. : Section 7 / Block 7 Lot (2a
CROSS STREET: 0.441, e
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential . Non-Residential '
• DATE OF PREVIOUS PUMP-OUT: / 9/-1
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.)
zjipeet_e_r_______ _ ?I__a_e..ze____e_e_
Signat a of Applicant
RECEIVED f:{r' - ,-.1: it �.i
Town Clerys Offic
DATE:
SEP 17 '. 5
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