HomeMy WebLinkAboutLambrou OFFICE OF THE:TOWN CLERK • i
c.AFOU(e+-
Town of Southold , 00 ��
Judith T. Terry, Town Clerk � ;
Town Hall, 53095 Main Road 1 -B
P. O. Box 1179 '1ta-.11W
Southold, New York 11971 `51. 3 e
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
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SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4-08,; Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool x
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- NAME OF OWNER: Fred H. Larnbrou -
OWNER MAILING ADDRESS: P.O. Box 1145
New Canaan, Connecticut 06840
OWNER PROPERTY ADDRESS: 1365 Aquaview Avenue
East Marion, New York 11939
OWNER TELEPHONE NUMBER: 516-477-0821
TAX MAP NO. : Section 22 Block 2 Lot 1
CROSS STREET: Cedar Drive -
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing x
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: April 24, 1987
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' Judith T. Terr
Southold Town Clerk
DATE: August 20, 1987 - -
(TOWN SEAL)
OFFICE OF THE TOWN CLERK SWFU(,I(�'=
Town of Southold �o CQ� Application No.961
Judith T. Terry, Town Clerk ��� •
Town Hall, 53095 Main Road ` Residential
P. O. Box 1179 u' ,; i ; Non-Residential
Southold, New York 11971 O .4
Telephone ®.( 416 'NO
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ /p`O D
DATE 7//1�� 7
OWNER NAME: Fe (� 1"1 LA-g1 r®2
OWNER MAILING ADDRESS: 9). 0e 3o
/1119 Cf914 (`f-- a 6c540
OWNER PROPERTY ADDRESS: Jc3 - sa .Gtr-epi e.A.7
A 1 vy YL?
OWNER TELEPHONE NUMBER: ar6')/7 9_01;22_ /
TAX MAP NO. : Section 2 Block Lot
CROSS STREET: CED/912 2 e1 " i~
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: Vr2-06)7
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.)
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Signature of Applicant
RECEIVED BY•,,. -
RE��Oown CIer�Yc's Offi e
DATE: AUfl201997
Town Clerk Southold
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