HomeMy WebLinkAboutKoster (2) •
OFFICE OF THE TOWN CLERK •
51 F -
Town of Southold � :- •
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road
P. O. Box 1179 n F;° *y{ - =. .
Southold, New York 11971 Qom` ;, •,,,,k�0���
Telephone O •
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
•
Operation Permit No. 435 Residential X
Fee $ 10.00 - Non-Residential
• • Septic Cesspool X
- NAME OF OWNER: Francis C. Koster
OWNER MAILING ADDRESS: 230 Columbia Road
Southold, New York 11971
OWNER PROPERTY ADDRESS: 230 Columbia Road
Southold, New York
OWNER TELEPHONE NUMBER: 516-765-2525
TAX MAP NO. : Section '79 Block 6 - Lot 12
CROSS STREET: Eds Road
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: Unknown
prlith T T(arYNi
Southold Town Clerk
DATE: September 18, 1987
(TOWN SEAL)
%`1 1
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OFFICE OF THE TOWN CLERK � .c,�FFD(A- "-
Town of Southold Application No.1- 5
�� _
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road a ,; } Residential
P. O. Box 1179 c _ a ' .z Non-Residential
Southold, New York 11971 O '00 ��`
Telephone
•
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
FL,r
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ /d: 19.-°
DATE Q'9- /S- 67
OWNER NAME: °` S • AA /
OWNER MAILING ADDRESS: 23. 2'i
,�o 77/0(D N 5.1 .
OWNER PROPERTY ADDRESS: ���/e
OWNER TELEPHONE NUMBER: 7‘L5--- 7.5-2e
TAX MAP NO. : Section 79 Block 6 Lot / v
CROSS STREET: e2 5' - 2D
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing t/
Residential 1/ Non-Residential
DATE OF PREVIOUS PUMP-OUT: -7/g-2
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.)
Signature o' pplicant
RECEIVED BY: L
1own Cler Officer
DATE: SEP 181987
Town Clerk Sold
-. 50'
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MAP OF "A t.
v';;zVEYD FOS
F' R.ANIC1 S C. KOST r .
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tn 13'
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SCALE: 40%. 11,- Guaranteed io The Int r-Cosutut4 TittE. Gt.iararitq and
tad fort pipe Mortgage Cortkranq ar.d fila SoirthOlot Sc1\inqs Salta
0 . i'.t onutr tit as surve•.tt.td 1"..,c k. :4, 1965
VA I LiYL. 4537k4 I
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