HomeMy WebLinkAboutmccourt OFFICE OF THE TOWN CLERK c FQL1C��
Town of Southold
Judith T. Terry, Town Clerk �,, ;
Town Hall, 53095 Main Road c g t..t
P. O. Box 1179 ‘cn } 0, _�
Southold, New York 11971 `'"� .10{-;e
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Telephone j
(516) 765-1801 »"
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 530 Residential x
Fee $
10.00Non-Residential
Septic Cesspool X
NAME OF OWNER: Kathryn L. McCourt
OWNER MAILING ADDRESS: 765 Brower Road
Mattituck, New York 11952
OWNER PROPERTY ADDRESS: 765 Brower Road
Mattituck, New York
OWNER TELEPHONE NUMBER: 516-298-8617
TAX MAP NO. : Section 139 Block 1 Lot 6
CROSS STREET: Mayflower Road
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: Never Previously Pumped
100640:0470
Judith T. erry
Southold Town Clerk
DATE: December 11, 1987
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(TOWN SEAL)
OFFICE OF THE TOWN CLERKS�FFil(,(C'
Town of Southold �� ..�- • � Application No.,-/-30
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road } Residential
P. O. Box 1179 cry AiF� Non-Residential
Southold, New York 11971 � -� xF=','
Telephone
Telephone .( 4111
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
RECEIVED
NOV 251987 APPLICATION
Town CIArk Southold for
-
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. S�v
Fee $ /b _
DATE /IL 17 2.0 fgg7
/1/1(-71M 'ISG 0C- •
OWNER N AM FAqc. ` 9 • nc- C U R."7—
OWNER MAILING ADDRESS:_ 7I,( Jif/) vi-// /1)64--AIS
,/t1
OWNER PROPERTY ADDRESS:
OWNER TELEPHONE NUMBER: � �c /7
TAX MAP NO. : Section /2 9 Block / Lot 6
CROSS STREET: ,- W J
TYPE OF- SYSTEM: Septic Tank New Existing
Cesspool 5- New Existing
Residential `X / Non-Residential
DATE OF PREVIOUS PUMP-OUT: /1/1JU,
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.)
Signa ure of Applicant
RECEIVED BY: / /, ) .
wn Cf rk's O `fice
RECEIV RECEIVED
DATE: IU
DEC 111997
Town Cork Southold town Cr( Southold -