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Home My WebLink AboutMcdonald ////,Iii If /" e® WireGym JUDITH T. TERRY L Town Hall, 53095 Main Road TOWN CLERK T • P.O. Box 1179 REGISTRAR OF VITAL STATISTICS �crl �` Southold, New York 11971 MARRIAGE OFFICER k✓ � Fax (516) 765-1823 ® � = 4,y®d 41 ' Telephone (516) 765-1801 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 3090-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New Existing X Name Of Owner MCDONALD, MARK Mailing Address 1 BOX 1258 Mailing Address 2 City St Zip SOUTHOLD NY 11971-0000 Property Address 1 MAIDEN LANE Property Address 2 City St Zip MATTITUCK NY 11952-0000 Owner Telephone No. 516-765-3677 Tax Map No. section 140.00 block 1 lot 10.000 Cross Street ROUTE 48 Date Of Last Pump Out 0/00/00 Issue Date: 8/17/93 Judith T. Terry Southold Town Clerk (TOWN SEAL) - OFFICE OF THE TOWN CLERK .‘kfFitt 2 Town of Southold •� CQG'` Application No. 30 9?) Judith T. Terry, Town Clerk k� " s Town Hall, 53095 Main Road . ... $10.00 - Residential t� � P. O. Box 1179 tri r` $25.00 - Non-Residential � .,, _` � Southold, New York 11971 O.y� Telephone .( `j► '� (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ • DATE OWNER NAME: M/\v-1. S ke:bOtA--akA OWNER MAILING ADDRESS: lk IZS- OWNER PROPERTY ADDRESS: OWNER TELEPHONE NUMBER: S16. 7G'S '30'7 TAX MAP NO. : Section IL-to Block Lot CROSS STREET: e-R-}- `-tom TYPE OF SYSTEM: Septic Tank New Existing Cesspool New Existing Residential O` Non-Residential DATE OF PREVIOUS PUMP-OUT: UNAe_ �,�wr• 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.) Signature o Applicant RECEIVED BY: Town Clerk's Office DATE: •-•,,,, ,, t'^'..-,;-r-"---t',...,,":-v•"^e.,:'';';-^" A. fo - -- -- - - C..--1--r*;.!,.'•v.:—-•ri• ,r.-.i.?.E'F.r4.7,e; ,i•.; t!'":- s t'..'F... ••-••,'"'e.-.4"..'';',.?.: ".Z'r c.--'...-- •..,:•_—-'':,-• '7.:^F,-.)c,.;1-4-ic.:.77_4:1 \;)1 a..7'...2.:-;-1:71':i:::1:::....-1,-:;-,.-.'-c:•.,NI-.1 7C.11 . Cr'• ..... -- 1-,--:-.,=:-,7:. --.- ,-; I-g•i.•- 1'.:-z.-).^1. i5-."4•Cf,•.-'-..r-- _..7-.'141*:-".---:,,...7 r,;:i 1 !;..1-.'r-, i-,_ :.„:-.1.1,,,,:-:1-,-,;,.:•;-,r,cr-il 1 . tzt;•_a---: ..,:-•_-;-•,:.'z:-,,..;2,-,r22,-iz.,,rov- H--- - -3-=' ,..— zi..r.---,.;"2,- -...-.h,-;--x•:ric,: itenA:,-,r.i.inli-: I tis.., ...',i -.--1 .r."1-..........1.MPS..Gc tat-.-01.7.1,ni. N. 44'44. 30 E ) r.. 1 )74,•:46 2-.: _- • 1 I . ..,---- - n (.) ...j 1...11 CeP.5.5ritA5 1..c? ! ,-) --- ) CD 41 "..,:.e. V .-i.. i --i C.., ..ii . . (2g) (\I CO.... _ --- .-- .fr _ ,-1 ---_._i I I . I I -1 ! -.,.. I . I( 2 k..." 5TORsi- PRA,N,E '.) ! .'... . ‘... . - . I (_-) ;NJ 1 • ill I-- --I •zr) _ __ _2 L./ ,__L; \ /-1----------1 0 LOi. ' l A,t.-• ; .,:.. -_ ,... A • ..— "T i .s,•':--: PA; :-_,:..,•,; ,-..:, - , •.....1‘,... •, G''. .-.,.... ! F 7 r•.-FT. , 1 (4;7, • i , 4,1'-1 4'r z n • ....,.... vs i . ......, -...•• 174.7 1' ( ' , \ ' E.POWN H ' ------- --- MA:4'A 4.--.,--,IGA . t ! : .2, I , 0 , i I , 0 CC 1---1 , i ' / if , , // E . • - , I /I .,. . . ir 1- ! r :.'11-' :- ...' ".- .7:.:r:' -.‘ :-..- r: - -. ',• Z 1 - _ . - - - - - - ---- -- -. z ',./ .: .''' .- -- .. ---i-`A j''''':\;•- i.-',"\'..2.,•,j 0.0,.....- .. .. -I • -.• i - , i I . .." • -- -- '.. _...,.. . _ / -I 1 - 7- i - - . 1 -- ." - ., , , , _ , - I i-/ - , . __ . - '.._ ---.• . _ /,.... ____ ,....._ _•. ..:L,- - 2 ,". .,, .. :7'2 _ •.. ... : /'-- _ , - ,,2 '''' . „ ir•.' .‘3:IT. -::, :. .."..... ; -1. . ' • -,. .. ' • •- _ \ ' rsi 1 ,, i ;-'_i.: I '-- . ' - - - -- -- —-- —-- . . • - ''1 .;. - --.1-_.,',; '. - ••„. ,., SAT E• .'_:_:___-__:_z__22:'_ • - — --- ---- ft ...,.. 0 r ''..:74.''...f.°.;AI C ....• 1 ..... . ,.., tP,, '-',"- . ,\t- A.• --- - , ,..., - •-; .-* , `,-- ,- 1- ,...dialdilli . ...L.sifirgia'