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HomeMy WebLinkAboutMcGirr O leo " . �' z Town Hall, 53095 Main Road P.O. Box 1179 y; > �c 4t Southold, New York 11971 JUDITH T.TERRY :� o TELEPHONE iii TOWN CLERK or// (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. 857-R Residential X Non-Residential Fee $ 10. 00 Septic Cesspool X New Existing X Name Of Owner MCGIRR, JOHN Mailing Address 1 P. O. BOX 816 Mailing Address 2 City St Zip CUTCHOGUE NY 11935-0000 Property Address 1 MIDWOOD ROAD AND HOLDEN ROAD Property Address 2 City St Zip CUTCHOGUE NY 11935-0000 Owner Telephone No. 516-734-6082 Tax Map No. section 110. 00 block 2 lot 11. 000 Cross Street CORNER LOT - HOLDEN & MIDWOOD Date Of Last Pump Out 0/00/00 Issue Date: 9/23/88 Judith T. Terry Southold Town Clerk (TOWN SEAL) • OFFICE OF THE TOWN CLERK c3�FF0/A- - —7 Town of Southold Q C' - Application No. �� / r oG Judith T. Terry, Town Clerk iy4 Town Hall, 53095 Main Road o 'r'rY K -4, 7 Residential to tti ,,, ,1 P. O. Box 1179 ���� �,.�� Non-Residential Southold, New York 11971 O ®. �i ter,. '._;- �' •.� Telephone "'Q( `��� .� (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: 10 /7/CI h r c C l!Q g OWNER MAILING ADDRESS: / /ip <-6/ C-/p ©l-(-v •‘,9G2.7�/(7 l 1./1. e c,7-e.,# til alt • 1(9.3y f', d ,5O'gl6 OWNER PROPERTY ADDRESS: M GP Cv®6 A®,4T> /-lo A( /{-(2G re-lo ge,e N V /('3S OWNER TELEPHONE NUMBER: 5/ 6 - - e6 pj 2 - TAX MAP NO. : Section / /0 Block 2-- Lot I CROSS STREET: /Z-trD LVI:-I TYPE OF SYSTEM: Septic Tank New Existing Cesspool V New Existing Residential V 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.) • Signature of Applicant RECEIVED BY: RE down Clerk's Office DATE: SEP 23198 Town Clerk Southold l l / (=_, .i; n- _ ", ;.= ;9 1-(01, 1k( A v6 6' r CO g' !� d L_ � /2- '-'1'--r->-*-21 . ...5 -a7-"47� _ C: � � d