HomeMy WebLinkAboutMcgahan 4,S°, • 0::\
B Town Hall, 53095 Main Road
1281'
/`� P.O. Box 1179
411, 10°•0° Southold, New York 11971
JUDITH T.TERRY /r���� TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 733-R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
New Existing X
Name Of Owner MCGAHAN, WALLACE A.
Mailing Address 1 LAKE DRIVE
Mailing Address 2 REYDON SHORES
City St Zip SOUTHOLD NY 11971-0000
Property Address 1 LAKE DRIVE
Property Address 2 REYDON SHORES
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 000-734-6270
Tax Map No. , section 80.00 block 4 lot 25.000
Cross Street GROVE DRIVE
Date Of Last Pump Out 0/00/00
Issue Date: 6/15/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK COMA'
Town of Southold `%,-" Application No. "i 3
Judith T. Terry, Town Clerk �'
Town Hall, 53095 Main Road oFt' �-
Residential
P. 0. Box 1179 l,, '' Non-Residential
Southold, New York 11971 ® � �o�,`�
Telephone 4
•
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for -
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 73 3
Fee $ /
•
DATE911.../(.?-e, lQ
OWNER NAME: W/?-L 4.4- co- r /I(e 6n#r/
OWNER MAILING ADDRESS: L-/ blilt, '�dN' � t
Set'r/ /-z /l-e1 7/
l
OWNER PROPERTY ADDRESS:
OWNER TELEPHONE TELEPHONE NUMBER:
TAX MAP NO. : Section aeo Block Lot (J�
CROSS STREET: U d0/-''•,
TYPE OF SYSTEM: Septic Tank New Existing )C
Cesspool New Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: /// GCVO te.ce
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 of - .licant
RECEIVED BY:c C&
Town 1erk's
DATE: (.(/x_2_ I S f or'Y
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CERTIFIED TO '
' COMMONWEALTH LAND TITLE
INSURANCE COMPANY
LONG ISLAND SAVINGS BANK SURVEY OF
WALLACE A . MC GAHAN
' MARY S. MC GAHAN LOTS I THRU 3 INC L .
" MAP OP REYDON SHORES — BLOCK H "
' FILED JULY 2 , 1931 FILE NO . 631
AT S`OUTHOLD
TOWN OF SOU THOL D
SUFFOLK COUNTY, N.Y.
AD LAN06, 1000 - 080 - 0 4 - 25
`�� Nt.M,P?�G�L SCALE 1 " = 30
y t 41 $ -4 JULY 21 , 1986
- ,
�‘-,4J2.lJte "� N.YS. LIC. NO . 4961 8
PECONIC SURVEYORS a ENGINEERS , P. C .
( 5 16) 76 5 - 5 0 2 0 Prepared in accordance with the minimum
standards for title surveys as established by
- P. 0. B O X 909 the L.I.A.L.S. and approved and adopted
MAIN ROAD for such use by The New York State Land
,S O U T H O L D , N . Y. 11971 Title Association.
. 86 - 377