HomeMy WebLinkAboutLenahan / /0,, i�
�/ �,
gl
JUDITH T. TERRY z Town Hall, 53095 Main Road
TOWN CLERK ® . T P.O. BOX 1179
REGISTRAR OF VITAL STATISTICS .` Southold, New York 11971
�✓ `
MARRIAGE OFFICER Fax (516) 765-1823
� O � •
,�/®1 ® Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3177-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner LENAHAN, MARY A.
Mailing Address 1 2245 MARLENE LANE
Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
Property Address 1 2245 MARLENE LANE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-5965
Tax Map No. section 144.00 block 3 lot 13.000
Cross Street PECONIC BAY BLVD.
"die
Issue Date: 2/28/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK •c3VFFOUr�'=
Town of Southold Q F. C 3177
� OG Application No.
Judith T. Terry, Town Clerk # �"
Town Hall, 53095 Main Road ,-;:' 'ti $10.00 - Residential
P. O. Box 1179 cn ��r
�.� $25.00 - Non-Residential
Southold, New York 11971 O ®
Telephone (/1 siP 0
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
Pi-"LJ CATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3/ 77
eJ
Fee $ / 1j
DATE 2 _ ) 7--
OWNER
_OWNER NAME: 2f
OWNER MAILING ADDRESS: 27-LK' )1/{1
/V`
OWNER PROPERTY ADDRESS: -
OWNER TELEPHONE- NUMBER:
TAX MAP NO. : Sections _ 73LS'YY Block Lot 13
CROSS STREET: es-vv,,,,; l/ =- - •
TYPE OF SYSTEM: Septic Tank New Existing `;
Cesspool 1 New Existing J�
Residential t/ 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.)
J 1
SiJ ature`o/ Applicant
RECEIVED BY: _, /;/
Town Ce''s Offic-
DATE:
_
f�J
t
19a//,'L