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HomeMy WebLinkAboutMcaffee JUDITH T. TERRY _ Town Hall, 53095 Main Road TOWN CLERK :. ,f P.O. Box 1 179 REGISTRAR OF VITAL STATISTICS ' , Southold, New York 11971 MARRIAGE OFFICER _ 3 Fax (516) 765-1823 •��,.� :' r%� �� �.' ' ' 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. 1598-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New Existing X Name Of Owner MCAFEE, WILLIAM H. Mailing Address 1 RR2, 310 ALVAHS LANE Mailing Address 2 City St Zip CUTCHOGUE NY 11935-0000 Property Address 1 310 ALVAHS LANE Property Address 2 City St Zip CUTCHOGUE NY 11935-0000 Owner Telephone No. 516-734-6084 Tax Map No. section 109.00 block 2 lot 3.000 Cross Street MAIN ROAD Date Of Last Pump Out 0/00/00 Issue Date: 1/17/91 Judith T. Terry Southold Town Clerk (TOWN SEAL) OFFICE O THE TOWN CLERK c�� HU( of Southold Q COG-- Application No./ 57/ .? , Judith T. Terry, Town Clerk 11'1') $10.00 - Residential Town Hall, 53095 Main Road P. O. Box 1179 (n :..'-: s` ,;.,. tri � $25.00 - Non-Residential Southold, New York 11971 O t '°- TelephoneOj • (516) 765-1801 • TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. - Fee $ • 'DATE C>=' M t;3E . 10j 'OWNER NAME: j LL\ ra m 11. W cAF C ' OWNER MAILING ADDRESS: RR a, 31 © I\ 1-.V Y-1 14 S L P '1 - Cvj" ch( o c� E./ ..�_ 119 3,..0 OWNER PROPERTY ADDRESS: 3 t m E - OWNER TELEPHONE NUMBER: 5 L- -13`-f - LO • TAX MAP NO. : Section Block Lot r ' CROSS STREET: 3,/6') ' /1�/Tj -tIIc1 C bi9-. We-sr TYPE OF SYSTEM: Septic Tank New Existing Cesspool New Existing Residential Vf Non-Residential DATE OF PREVIOUS PUMP-OUT: • 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.) 6 /iere; 74M/Ct Signature of Appli,-nt RECEIVED BY: Town Clerk's Office DATE: - 6 , V ' s:---•'tea• /,<-fr;\ cc; 1 . i?) 24„, Cs V ) H ALE ,