Loading...
HomeMy WebLinkAboutKiernan iiT`�11 E it.p..g�.�� �ilffUt6�/rr- / _- a r� Town Hall 53095 Main Road P.O. Box 1179 Southoldi, New York 11971 JUDITH T.TERRY 01-� FAX(516)765-1823 TOWN CLERK TELEPHONE(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. 1403-R Residential X Non-Residential - - I Fee $ 10.00 Septic Cesspool X New _ Existing X Name Of Owner KIERNAN, F. J. AND BETTY Mailing Address 1 SCHOLL, MARCO Mailing Address 2 1600 GIN LANE City St Zip SOUTHOLD NY 11971-0000 Property Address 1 600 CLEARVIEW WEST Property Address 2 City St Zip SOUTHOLD NY 11971-0000 Owner Telephone No. 516-765-1599 Tax Map No. section 70.00 block 8 lot 48.000 Cross Street GARDINERS LANE Date Of Last Pump Out 0/00/00 Issue Date: 3/08/90 Judith T. Terry Southold Town Clerk (TOWN SEAL) °s OFFICE OF THE TOWN CLERK Town of Southold � .:jam l�G• Application No. / b� Judith T. Terry, Town Clerk f i } Town Hall, 53095 Main Road p10.00 - Residential P. O. Box 1179 u' r-``AYi z $25.00 - Non-Residential Southold, New York 11971 O4t *" O��J, Telephone = 1 '� (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD 'WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL OperationPermitlNo. Fee $ /010-0 DATE 3/r00 OWNER NAME: FT, kierran1B*if i ?ernes b San` i • OWNER MAILING ADDRESS: `660 C411, 1.-CIA ►C 61n4-04114I Airy. � tq°71 OWNER PROPERTY ADDRESS : 4.60 Clea -v-16J 14)&5 < Nem 144 , N.Y. ti/7/ OWNER TELEPHONE NUMBER: 676' TAX MAP NO. : Section 0 70, et° Block 6$,66 Lot (a 92,60e, CROSS STREET: O -cb r'e TYPE OF SYSTEM: SepticTank New Existing Cesspool New Existing Residential Non-Residential DATE OF PREVIOUS PUMP-OUT: 11/30/81 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.) . it<44,2424„..----)e- Signature of Applicant RECEIVED BY: ' Town 'Clerk's Office DATE: KiERA144 ?XP i V — 666 C E.4QvVEW t.ESr SoLLrbai-ti r Ai eY, gyms 2t..E1a-kV L EW \\ ...______,,,______ ______---- --/ €) N B 'i tv,4frr Ouse_ z. fl ii,'RAG E_ f,, '7 " 16` i&' 0' 0 CD C 55it©... CESSPoo t. cr.:.-5S-Poo ` EM> EAD