HomeMy WebLinkAboutMcCarthy (2) OFFICE OF THE TOWN CLERK • •c0FOLke►"
Town of Southold �� OG
Judith T. Terry, Town Clerk � _ 4
Town Hall, 53095 Main Road "� '�ti
P. 0. Box 1179 �� _
Southold, New York 11971 ti ' �- •�
Telephone _ 1i
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 215 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool x •
NAME OF OWNER: George A. McCarthy
OWNER MAILING ADDRESS: 1900 Any Street
Laurel, New York 11948 - •
OWNER PROPERTY ADDRESS: 1900 Any Street
Laurel, New York
OWNER TELEPHONE NUMBER: 516-298-5825
TAX MAP NO. : Section 125 Block 3 Lot 2.1
CROSS STREET: Main Road, -Route 25
TYPE OF SYSTEM: Septic Tank X New Existing x
Cesspool X New Existing x
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: None
Judith T. Terry
Southold Town Clerk
DATE: February 4, 1987
(TOWN SEAL)
OFFICE OF THE TOWN CLERK S `CFour" •
Town of Southold �� � '; Application No. o?j,_S--
Judith T. Terry, Town Clerk 4= � Residential
Town Hall, 53095 Main Road 's
P. O. Box 1179cn �:,�-�� '' `
4,� � �' Non-Residential
Southold, New York 11971
Telephone o'l 4c
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No /6
Fee $ /® 5--
DATE
OWNER NAME: ,fid 2�a L' A /tic�� )4. y
OWNER MAILING ADDRESS: /?CO 4/V 77,
OWNER PROPERTY ADDRESS: / V
OWNER TELEPHONE NUMBER: C57‘ —c9—?Y----
TAX
‘ —c9— / Y----TAX MAP NO. : Section / o�j'` Block 3 Lot
CROSS STREET: Q,z,v, ,��( , redled-6- c=2,9/
TYPE OF SYSTEM: Septic Tank ✓ New Existing L!
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.)
Sign- 4,-re of Apr icant r
RECEIVED BY: (X�C d.ci_._ Add._
RECEW
Dn Cle c's Offic/
DATE: FEB 04 1987
Town Clerk Southold
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