HomeMy WebLinkAboutMcCabe OFFICE OF THE TOWN CLERK ".c0FO(, O+D_
Town of Southold Q ,
Judith T. Terry, Town Clerk � :; .4•_ .�
Town Hall 53095 Main Road r" '
P. O. Box 1179 ,,sn k Y
Southold, New York 11971 d `- ' �- •'
Telephone �lglt
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 571 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool X
NAME OF OWNER: Margaret P. McCabe
OWNER MAILING ADDRESS: P.O. Box 976
Mattituck, New York 11952
OWNER PROPERTY ADDRESS: Main Road
Mattituck, New York
OWNER TELEPHONE NUMBER: 516-298-4555
• - TAX MAP NO. : Section 142 Block 2 Lot 20
CROSS STREET: Legion Avenue
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: 12-1-86
—� Juith T. Te�
Southold Town Clerk
DATE: January 11 , 1988
(TOWN SEAL)
OFFICE OF THE TOWN CLERK cOF DCA-
Town of Southold moo CQG Application No. _1/
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road *-&.%mi • Residential
P. O. Box 1,179 cni
,.�, ma � Non-Residential
Southold, New York 11971
Telephone Z01eltIo;"
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 6-2/
Fee $ /.0,
DATE I — T g
OWNER NAME: a Y G \r--e_Tr D`, "c C/4 �-
,p r.
OWNER MAILING ADDRESS: l` ' Q, BOX 9 ? M' c,( '' e C/9 Q/
/'tCI- T7- iT C ,� 1 A/ew1 Itg52_
OWNER PROPERTY ADDRESS: S,1 iM L. 1
OWNER TELEPHONE NUMBER: ( 5. 16) a ci g 7'S5TS
TAX MAP NO. : Section / l Z Block Z Lot 20
CROSS STREET: ec-1 b N PVC ,
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool )( New Existing )(
Residential ,( Non-Residential
DATE OF PREVIOUS PUMP-OUT: I - / .?6
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.)
-24/ ))//(# 0.0C/hnature of Applicant
RECEIVED BY:
RECEwurown ellerlffice
DATE: JAN 111987
Tnurn Clark Southold
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