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Home My WebLink AboutKron 01 OFF 01 4. tNir ® ELIZABETH A.NEVILLE .k1 tok; Town Hall, 53095 Main Road TOWN CLERK i ® P.O. Box 1179 +' Southold,New York 11971 REGISTRAR OF VITAL STATISTICS Fax(516) 765-1823 MARRIAGE OFFICER � 4 ` / Telephone (516) 765-1800 RECORDS MANAGEMENT OFFICER ® 1 FREEDOM OF INFORMATION OFFICER �� 0 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 3755-R Residential X Non-Residential Fee $ 10.00 New Existing X Name Of Owner KRON, GARY R. Mailing Address 1 980 NEW SUFFOLK AVENUE Mailing Address 2 City St Zip MATTITUCK NY 11952-0000 Property Address 1 980 NEW SUFFOLK AVENUE Property Address 2 City St Zip MATTITUCK NY 11952-0000 Owner Telephone No. 516-298-9519 Tax Map No. section 114.00 block 12 lot 9.000 Cross Street OLE JULE LANE Issue Date: 1/22/98 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) • • . 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OFFICE OF THE TOWN CLERK •4\fFUt'ir - Town of Southold �� CQG:� Application Judith T. Terry, Town Clerk • y Town Hall, 53095 Main Road - $10.00 - Residential P. O. Box 1179 •.t ;' ;' $25.00 - Non-Residential Southold, New York 11971 O �` Telephone ?t `ts (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT • APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ in. cr) DATE 1/ 15-1q ? OWNER NAME: Gary P. a l^on OWNER MAILING ADDRESS: q O heti) SSG) k OWNER PROPERTY ADDRESS: YyL _ as aid OWNER TELEPHONE NUMBER: caC -- C15 (9 TAX MAP NO. : Section Block 7 iI'`t,"/o�-9 CROSS STREET: Ca cR. _ )&, � TYPE OF SYSTEM: Septic Tank New Existing Cesspool X New Existing Residential 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.) 2.. tom Signatu e of Applicant RECEIVED BY: Town Clerk's Office DATE: