HomeMy WebLinkAboutKanellopoulos OFFICE OF THE TOWN CLERK c0FOCXCD
Town of Southold �o - lj
Judith T. Terry, Town Clerk ti L
Town Hall, 53095 Main Road
P. O. Box 1179 �,�v' ' �� <= 41 :
Southold, New York 11971 `� ® �� ' .�
Telephone _ oIkVA I
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
•
SEPTIC TANK or CESSPOOL
Operation Permit No. 486 Residential x
Non-Residential
Fee $ 10.00
Septic Cesspool x
NAME OF OWNER: Haralambos Kanellopoulos
OWNER MAILING ADDRESS: 31-12 42nd Street
Astoria, New York 11103
OWNER PROPERTY ADDRESS: Parkview Lane and Ryder Lane
Orient, New York 11957
OWNER TELEPHONE NUMBER: 718-728-4516
TAX MAP NO. : Section 15 Block 5 Lot 24.23
CROSS STREET: Ryder Farm Lane
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool x New X Existing
Residential x Non-Residential
DATE OF PREVIOUS PUMP-OUT: NA
•
7udit r
Southold Town Clerk
DATE: November 17, 1987 _
(TOWN SEAL)
OFFICE OF THE TOWN CLERK OFO
Town of Southold �� tCQG Application No.
Judith T. Terry, Town Clerk � ,`Z` ` Residential
Town Hall, 53095 Main Road 1 :,s :G�
ni
P. O. Box 1179 ; Non-Residential
Southold, New York 11971 O ®�' _'r'�
Telephone - 1i
(516) . 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. Li n
Fee $ /b 1
_ . DATE )`° iY1
OWNER NAME: HarculamiDos 761ie
OWNER MAILING ADDRESS: 3'1 J 2- 1S+y'e_L.t
fr5- ( Gt— IV ur it 1 o 3
OWNER PROPERTY ADDRESS: ,PO 1CVI&J k pe-{" La)tL
OWNER TELEPHONE NUMBER: .1I 8 -7)---g 4S-1 (o
TAX MAP NO. : Section 1S- Block Lot 2 L® 2 3
CROSS STREET: l� ( Farm 1_0 v�
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New ✓ Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT:
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.)
Si nature of - pplicant
RECEIVED BY:
REcElyE frown CI rk's Off ce
DATE: NOV 17187
Town Cterk Southold