HomeMy WebLinkAboutKettenbeil OFFICE OF THE TOWN CLERK • • FO
Town of Southold ���� 1-wire
Judith T. Terry, Town Clerk ; ` ek
Town Hall, 53095 Main Road
P. 0. Box 1179 cn
Southold, New York 11971 •
Telephone Alal
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(516) 765-1801
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
- OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 283 Residential
Non-Residential
Fee $ 10.00
Septic Cesspool x
NAME OF OWNER: Alfred and Clarasue Kettenbeil
OWNER MAILING ADDRESS: Seawood Drive
Southold, New YOrk 11971
OWNER PROPERTY ADDRESS: Seawood Drive
Southold, New York
OWNER TELEPHONE NUMBER: 516-765-5576
TAX MAP NO. : Section 79 Block 7 Lot I 60,
CROSS STREET: Between N. Bayview and Main Bayview
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: Unknown
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Judith T. Terry
Southold Town Clerk
DATE: April 22, 1987
(TOWN SEAL)
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OFFICE OF THEA WN CLERK C3IFfi(,(�C'
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Town of Southold ��
Q Application No
Judith T. Terry, Town Clerk � . �+
_ Residential
Town Hall, 53095 Main Road
P. O. Box 1179t _ ` i �`' Non-Residential
Southold, New York 11971 O •
0���`
Telephone vfe_ ,( '
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERAT ION PERMIT
SEPTIC TANK or CESSPOOL
• i
Operation Permit No.
Fee $ • DATE Li' 13 c7
OWNER NAME: 111- 64-0 C-4--ALA SVC, \ 1i J
OWNER MAILING ADDRESS: Ye-At4J0-0 ¢ "Dr..,Q lle�i
u� ,J l±o 6N,) 4) �4,1C- ( 1 9 1 I
OWNER PROPERTY ADDRESS: � d� yZls;,•-/
OWNER TELEPHONE NUMBER: JAI G P G S-a GS'? 6
TAX MAP NO. : Section ®� Block 0 1 Lot 0( 0
_
CROSS STREET: Pr-4 'IYtiI A1-0 raAYV i e:
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool t/ New Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: t1,i11t o,..)
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.)
04, 'ONO ' sf
Si nature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
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1 64:04/20 •
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- �}, .NAUTMORILEO ALTETATION OR ADDIiI / �1
1 i i f0 THiS SURVEY IS A VIOLATION OF
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