HomeMy WebLinkAboutMckay (2) OFFICE OF THE TOWN CLERK v3 4 S�FFO(/r�0
Town of Southold y-
Judith T. Terry, Town Clerk ri'
Town Hall, 53095 Main Road g IS•.
P. 0. Box 1179to _
Southold, New York 11971 \ QyY; '
sicc
Telephones
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 626 Residential X
Fee $ 10.00 Non-Residential
Septic Cesspool X
NAME OF OWNER: James H. McKay
OWNER MAILING ADDRESS: 495 Bennett's Pond Lane
Mattituck, New York 11952
OWNER PROPERTY ADDRESS: 495 Bennett's Pond Lane
Mattituck, New York
OWNER TELEPHONE NUMBER: 516-298-5914
TAX MAP NO. : Section 113 Block 13 Lot 13
CROSS STREET: Westphalia Road
TYPE OF SYSTEM: Septic Tank New Existing I,
Cesspool X New Existing x
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: Unknown
•
Judith T. Te ry
Southold Town Clerk
DATE: February 25, 1988 - -
•
•
-_(TOWN SEAL)
•
•
OFFICE OF THE TOWN CLERK - S��Fp�
Town of Southold �% CQG' , Application No. 6 0247
Judith T. Terry, Town Clerk y
Town Hall, 53095 Main Road Residential
P. O. Box 1179 f 7 ► � Non-Residential
Southold, New York 11971 •
O ' '
Telephone *11.411i-
.(-'y 0-1°96.`
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ A9,00
DATE o2/2:.-lit,!?
OWNER NAME: NJ W1.e S
OWNER MAILING ADDRESS: l ex -e_1+
n
c(-
VA _t �-.
6 ±(40-k ALy ( ( 9 S -
OWNER PROPERTY ADDRESS: - Jia rM -�
OWNER TELEPHONE NUMBER: Zig g
L-f,
TAX MAP NO. : Section / / 3 / Block / 3 Lot /3
CROSS STREET: �2.5f/J`jct / f q
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool y New Existing k
Residential `Sc.-- Non-Residential
DATE OF PREVIOUS PUMP-OUT: 4/e7
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 Applic-
RECEIVED BY: _
Town Clerk's Office •
DATE: _ -
, •_, .,
. .
ar i' 11
il
I . l'
5 ,P5 - L. ct ,
, _......... . 1
il
il
. i
I(
i o 1I
.... .....
i c '
. 0 v • .,
e
II
y .
1
1- -
1 ' .
, 11
I
11 •
• 5 e
4_.... • _. .
.............. 11
. .
11
s , .
. 1
4 1
_I =_ , ,I
,i
1,
. 1
I- .-
• ,
,
I1
11
I
il. .
_.,.
,t
., If
. 11
I
1 .
. k---- ., 0 ,) 1
i
11 '
. 9 .
1
. 11
;III
il
II
111
. - 11111
• 11
I . It