HomeMy WebLinkAboutMcBride (2) 711
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JUDITH T. TERRY g ® Town Hall, 53095 Main Road
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TOWN CLERK '' P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ® Southold, New York 11971
MARRIAGE OFFICER : f, $ Fax (516) 765-1823
0��� 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. 1688-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner MCBRIDE, FRANK AND SONS
Mailing Address 1 OREGON ROAD
Mailing Address 2
City St Zip CUTCHOGUE NY 11935-0000
Property Address 1 OREGON ROAD
Property Address 2
City St Zip CUTCHOGUE NY 11935-0000
Owner Telephone No. 516-734-6068
Tax Map No. section 83.00 block 2 lot 15.000
Cross Street DUCK POND ROAD/DEPOT LANE
Date Of Last Pump Out 0/00/00
Issue Date: 5/07/91 Judith T. Terlir
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK c0FHU( -
Town of Southold ._;i �QG; Application No.a kb
Judith T. Terry, Town Clerk - ;:' "•••."4 $10.00 - Residents
Town Hall, 53095 Main Road
P. O. Box 1179 ±,(7! • $25.00 - Non-Residential
Southold, New York 11971 O •®_
Telephone 0( l��•
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 1ggc?
Fee $ / a. as
DATE 30 /7 p/
OWNER NAME: 1' _�
OWNER MAILING ADDRESS: �/21
//73s
OWNER PROPERTY ADDRESS:
OWNER TELEPHONE NUMBER: 735L- ‘ O ,(/
TAX MAP NO. : Section k Block d2 Lot /��
CROSS STREET: �L,t_ckc PAue4 Rc . l LA°,pnf- I GLAIL
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool ✓ New Existing
Residential ' 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.)
C 4r --(10ee
Signature of Applicant
RECEIVED BY: ;,!/" /'--__,J
' own lerk's ',office
'' DATE: ��