HomeMy WebLinkAboutKanz L
B * Town Hall, 53095 Main Road
t. y® ���t� P.O. Box 1179
_ r-� Southold, New York 11971
JUDITH T.TERRY -®'1-w ,, ��� TELEPHONE
TOWN CLERK (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. 652-R Residential X Non-Residential
Fee $ 10. 00 Septic Cesspool X
New Existing X
Name Of Owner KANZ, WILLIAM JR.
Mailing Address 1 KANZ, NANCY A.
Mailing Address 2 P. O. BOX 1
City St Zip ORIENT NY 11957-0000
Property Address 1 1815 VILLAGE LANE
Property Address 2
City St Zip ORIENT NY 11957-0000
Owner Telephone No. 516-323-3563
Tax Map No. section 25. 00 block 3 lot 9. 000
Cross Street FLETCHER STREET
Date Of Last Pump Out 0/00/00
/-5/
Issue Date: 3/16/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
1 ,
o _,
OFFICE OF THE TOWN CLERK c COT- LA'
Town of Southold CP '; Application No. (-6)-
Judith T. Terry, Town Clerk .
. Residential
'serf Hall, 53095 Main Road f ,;;
P. O. Box 1179 u" tt.T. e. ► ; Non-Residential
Southold, New York 11971 � ;%°-.°1
$
Telephone .(
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION'
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE MaA4, '� reg
•
OWNER NAME: WI cam ecorr-41/c'- • AfGI'.d�C A K/�'iv�-
j
OWNER MAILING ADDRESS: P.C.- (2)d)(.. 1.
•
Orieti-F iVeal) if 7
OWNER PROPERTY ADDRESS: "ID3(/ (47_4e 40A�
Qk7e-074if 1e i �c���� /&67
OWNER TELEPHONE NUMBER: 6 3a3-3563
TAX MAP NO. : Section 0( :) . Block 3 Lot — 9
CROSS STREET: f/e-Ich e.e-*
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool 1/ New Existing
Residential V Non-Residential
DATE OF PREVIOUS PUMP-OUT: —ThQk' , , / 7g4
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-/0/1///2,,-
Sign ure of Applicant
RECEIVED BY: -
Town Clerk's Office
DATE: - •
*
i� 12- is4.:/pCLQ)'
c-) .151 -L
. � I
KA-07- i (z-
V i1 Lane,
- 8 '
ill
0. Cp.FS C
Town Hall, 53095 Main Road
En � ���' P. 0. Box 1179
Are.. Southold, New York 11971
�
Judith T. Terry �1 ''�I Telephone
•
Town Clerk (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Enclosed herewith is a copy of a letter which was sent to you several months
ago. As_of,this time we have not received your response. Please be
advised that it is very important that you complete the application and return
it to this office along with the location map and proper fee.
The Scavenger Wastes Law, which went into effect July 1986, states that every
Cesspool/Septic Tank system must have an Operation Permit. In accordance
with that law, each owner of a .Cesspool/Septic Tank system is notified to
obtain the Operation Permit after any maintenance or pumping has occurred.
By the end of the year 1990, all systems within Southold Town must be
registered and have an Operation Permit, even if there has not been any
maintenance or pump-out involving the system. You will not be asked to obtain
an Operation Permit each time you have work done on the system, the permit
is only issued one time for each system.
Enclosed, for your convenience, is another application and Informational
Bulletin. Please do not ignore this request. If you have any quesrtions or- •
need any assistance with the application please do not hesitate to contact this
office. We will be most happy to assist you in any way we possibly can.
Very truly yours,
•
Judith T. Terry
-Southold Town Clerk
Enclosures - - -
/Ijc -