HomeMy WebLinkAboutMccray ELIZABETH A.NEVILLE �® v . ® lkTown Hall, 53095 Main Road
•
TOWN CLERK ; ® P.O.Box 1179
co i $ Southold,New York 11971
REGISTRAR OF VITAL STATISTICS 'I Fax(516) 765-1823
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER �,4. ® �� Telephone(516) 765-1800
o� ��
FREEDOM OF INFORMATION OFFICER ®1 `° „��
•
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3841-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner MCCRAY, BETTY L.
Mailing Address 1 900 CEDAR DRIVE
Mailing Address 2
City St Zip SOUTHOLD NY 11971-0000
Property Address 1 SAME
Property Address 2
City St Zip 00000-0000
Owner Telephone No. 516-765-2258
Tax Map No. section 78.00 block 9 lot 3.000
Cross Street BAYVIEW AVENUE
• -4' A / /0
Issue Date: 12/21/98 E izabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
.. D W
"OFFICE
OWN OrSOTOWN UfHOLDERK �OC� FF�(�'`,G � Application No. .3
ELIZABETH A.NEVIJ.I.F,TOWN CLERK $10.00 - Residential
P.O.BOX 1179
SOUTHOLD,NEW YORK 11971 r
1�,� $25.00 - Non-Residential
Off'
• - , -- Telephone 40 4,
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATEI.Qd , (0, )6(•q g
•
OWNER NAME: 6q1-1) f . 1'\CCk
OWNER MAILING ADDRESS: P(7o Ca(*
.(1)u �c ��•� LID ,0 . '� r t 1
OWNER PROPERTY ADDRESS: \S ,,,,t
OWNER TELEPHONE NUMBER: ' 7 5 - 2 5
TAX MAP NO. : Section)( ,t -7 Block Lot
CROSS STREET: 76A- 4\•li
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool , New Existing t„./'
Residential Non-Residential
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.)
eee,
Signatu a of Applican
RECEIVED BY: / •
• -r,; a �` = t!<r s Office
DATE: DEC i 5 1996-
if. ;TL. ,F:i Mar
C , KrzikM _< vv'' , r J
_go r____ ,.
er,('\=9 0
,0 ,,,,, 2-Ab--AICC
' P(k°f
i
,
0.4,Y
cI l r/, 99