HomeMy WebLinkAboutMcCleery OFFICE OF THE TOWN CLERK • • • Fa
Town of Southold , 0��� 'affix--
Judith T. Terry, Town Clerk Z
Town Hall, 53095 Main Road ti
P. 0. Box 1179 � Ala
Southold, New York 11971 Q ® �- •�
Telephone ?t 4 •
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER 'DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 335 Residential X
Fee $ 10.00 Non-Residential
Septic Cesspool x
NAME OF OWNER: Arthur H. McCleery
OWNER MAILING ADDRESS: 1985 Skunk Lane
Cutchogue, New YOrk 11935
OWNER PROPERTY ADDRESS: 1985 Skunk Lane
Cutchogue, New York
OWNER TELEPHONE NUMBER: 516-734-5448
TAX MAP NO. : Section 97 Block 4 Lot 70
CROSS STREET: Eugene's Road
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing x
Residential X Non-Residential
DATE OF PREVIOUS,PUMP-OUT: Unknown -
Judith T. Terry
- Southold Town Clerk
DATE: July 15, 1987
(TOWN SEAL)
i
OFFICE OF THE TOWN CLERK SOFU(ir�'-
Town of Southold �o CQG Application No. 3 3S
Judith T. Terry, Town Clerk ' '
Town Hall 53095 Main Road ,sift. x , Residential
P. O. Box 1179 17.01i : Non-Residential
Southold, New York 11971 O �.
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for - -
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE ) V-42
OWNER NAME: 4e-40t, /1 / / c e e2
OWNER MAILING ADDRESS: /g Ts-- S'/i/,U/'( Lam,
OWNER PROPERTY ADDRESS: v 49
OWNER TELEPHONE NUMBER: 7 34- SW
TAX MAP NO. : Section C17 Block Lot ./0
CROSS STREET:
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New �xistin�
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.)
71
— 4d`'g-0 .e
0 Kul 11/11A-ce
Signature of Appli nt
RECEIVED BY:
Town Clerk's Office
DATE: