HomeMy WebLinkAboutKimogenor Point JUDITH T.TERRY ��; Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
PlySouthold New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER ®, � ����, Fax(516) 765-1823
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RECORDS MANAGEMENT OFFICER ®°� spe ��go.� Telephone(516) 765-1800
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. 3688-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner KIMOGENOR POINT
Mailing Address 1 C/O EDWARD A. PURCELL
Mailing Address 2 P. O. BOX 661
City St Zip NEW SUFFOLK NY 11956-0000
Property Address 1 PURCELL PROPERTY
Property Address 2 KIMOGENOR POINT ROAD
City St Zip NEW SUFFOLK NY 11956-0000
Owner Telephone No. 516-734-5272
Tax Map No. section 117.00 block 10 lot 1 .000
Cross Street JACKSON STREET
Issue Date: 9/17/97 Judith T. Terry
Southold "gown Clerk
• (TOWN SEAL)
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OFFICE OF THE TOWN CLERK c�VFFUL,(�
Town of Southold �� CQG Application No. 3
Judith T. Terry, Town Clerk .` y
Town Hall, 53095 Main Road a -< $10.00 - Residential
P. O. Box 1179 v' i ‘i
$25.00 - Non-Residential
Southold, New York 11971 O
Telephone jjit •
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE, -#/2/%7
•
OWNER NAME: Kimogenor Point
OWNER MAILING ADDRESS: c/o Edward A. Purcell
P. O. Box 661 , New Suffolk NY 11956
OWNER PROPERTY ADDRESS: Purcell property, Kimogenor>>Point Rd.
New Suffolk, New York 11956
OWNER TELEPHONE NUMBER: 516-734-5272 (Purcell)
TAX MAP NO. : Section 117 Block 10 Lot 1
CROSS STREET: Jackson Street
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New -Existing X
Residential X 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.)
/ Grp C Gi 7Lee---)
Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE: Q -' /5'1 2 -
**Location Map filed with Cesspool Construction/Alteration Permit No. 1801