HomeMy WebLinkAboutHovey ,i,,i �01FF0`
ELIZABETH A.NEVILLE is O. ®*A; Town Hall, 53095 Main Road
TOWN CLERK ; ® P.O. Box 1179
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS /Iv Fax (516) 765-1823
MARRIAGE OFFICER � ®�00 Telephone(516) 765-1800
RECORDS MANAGEMENT OFFICER \-74146
411
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. 3762-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner HOVEY (MARELLA), MARY
Mailing Address 1 4500 OLE JULE LANE
Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
Property Address 1 4500 OLE JULE LANE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-1059
Tax Map No. section 122.00 block 4 lot 32.000
Cross Street
Issue Date: 2/13/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
II•
OFFICE OF THE TOWN CLERK SIFFO(,r�'-
Town of Southold �� +t; CQ ';, Application No.3 7' __
Judith T. Terry, Town Clerk �� r `) $10.00 - Residential
Town Hall, 53095 Main Road g _ .^
P. O. Eox 1179 �' _` i `' $25.00 - Non-Residential
Southold, New York 11971
Telephone70 K •
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLI CAT ION
for
OPERATION PERMIT
•
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE -77/_(/7
OWNER NAME: 1/141A-441 t1i 1 � '✓L`=- CC1'�
OWNER MAILING ADDRESS: L(�- v-0 dL t J VL(_
OWNER PROPERTY ADDRESS:
OWNER TELEPHONE NUMBER: � j 3 / ® JP
TAX MAP NO. : Section Block Lot
CROSS STREET:
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool - New Existing
Residential Non-Residential
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.)
/ `
l
Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
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