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HomeMy WebLinkAboutMckillop JUDITH T. TERRY z . L Town Hall, 53095 Main Road TOWN CLERK ® T P.O. Box 1179 REGISTRAR OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER ��®� , Fax (516) 765-1823 ,y®1 �� 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. 3111-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New Existing X Name Of Owner MCKILLOP, JAMES AND EILEEN Mailing Address 1 135 BARWICK BLVD. Mailing Address 2 City St Zip MINEOLA NY 11501-0000 Property Address 1 1265 WUNNEWETA ROAD Property Address 2 City St Zip CUTCHOGUE NY 11935-0000 Owner Telephone No. 516-7111-3568 Tax Map No. section 111 .00 block 4 lot 28.000 Cross Street VANSTON ROAD Date Of Last Pump Out 0/00/00 Issue Date: 9/23/93 Judith T. Terry Southold Town Clerk (TOWN SEAL) OFFICE OF THE TOWN CLERK c0F0(A." Town of Southold �� - CQG Application No. ,_?//7Judith T. Terry, Town Clerk ky Town Hall, 53095 Main Road ` `>; . 7. $10.00 - Residential a P. O. Box 1179crs �z - $25.00 - Non-Residential Southold, New York 11971 o.,` .• Telephone %o.( (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for c;. OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ /61.,.6° = - _ - - DATE 406P57-G./ 9�3 _ OWNER NAME: OTLy/Y/ a- L M ���/Lo/' r _ _ W ONER MAILING ADDRESS: /3S B/i-/� i til &k 6-1/ _ ieV1..�/1.j !Y J . //so,/ OWNER PROPERTY ADDRESS: /',mss OWNER TELEPHONE NUMBER: -674 -71741-3S-Ar TAX MAP NO. : Section /// Block Lot ,$ CROSS STREET: VA/1/STL7N Re, ap TYPE OF SYSTEM: Septic Tank - New Existing Cesspool 1." New Existing 1' • Residential V Non-Residential DATE OF PREVIOUS PUMP-OUT:- iiii(Hsrncr� / 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.) Nkk, • to. 16uki • Sign. - of'Appl scant, • RECEIVED BY: � � //J - Town 'ler 's Office DATE: RECEIVED AUG 3 01993 Town Clerk Southold 1W. • A/,9 55,4 L[ P©i A/T R, /5 L 0-E55 oot-s 14 006- l'2-65 Via v►wew--az- 7- 0 d