HomeMy WebLinkAboutMckay OFFICE OF THE TOWN CLERK
Town of Southold
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road c ,644
P. O. Box 1179 �. ,$•
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Southold, New York 11971 O
Telephone
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(516) 765-1801 •
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. q Residential X
Non-Residential
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Fee $ 10.00
Septic Cesspool x
NAME OF OWNER: Anna F. McKay
OWNER MAILING ADDRESS: 95 Osborne Avenue
Riverhead, New York 11901
OWNER PROPERTY ADDRESS: Main Road
Mattituck, New York 11952
OWNER TELEPHONE NUMBER: 516-727-0946
TAX MAP NO. : Section 115 Block 6 Lot 7
CROSS STREET: Cardinal Drive
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing x
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: Unknown
Judith T. 'erry
Southold Town Clerk
DATE: November 10, 1987 ; rid
(TOWN SEAL)
OFFICE OF THE TOWN CLERK cOFD(,r
Town of Southold Application No. 4f.2.
Judith T. Terry, Town Clerks
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Town Hall 53095 Main Road � `' ''�'�: ' ''� Residential .rte
P. 0. Box 1179 ul w'' "i �' Non-Residential
Southold, New York 11971 �® •
Telephone : 1 •
(516) 765-1801
C �V � TOWN OF SOUTHOLD
NOV 041987 SOUTHOLD WASTEWATER DISPOSAL DISTRICT
lows SOuth®ld
APPLICATION
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 9re?—'
Fee $ 10.00
DATE 11/3/87
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OWNER NAME: ANNA F. MCKAY
OWNER MAILING ADDRESS: 95 Osborn Ave.
Riverhead, N.Y. 11901 .
OWNER PROPERTY ADDRESS: Main Rd.
Mattituck, N.Y.
OWNER TELEPHONE NUMBER: 727-0946
-�• y� _ �/ — 7 Lam: 4ems
c00.0 / /30 TAX MAP NO. : Section
Black •--712,2 Lot g o
$1-1( !
CROSS STREET: /7/4�L.,E L. P
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: Oct. 1987.
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 App • fit
RECEIVED BY:
Town Ck's Of ice
RECEIVED
DATE: A10IV 1 0
Town Clerk Southold
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