HomeMy WebLinkAboutMcmahon ,,„„
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4.41.1
„.7 Town Town Hall, 53095 Main Road
N •'� P.O. Box 1179
�Q( `N�. Southold, New York 11971
JUDITH T. TERRYrrr��,I, TELEPHONE.
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTfC TANK or CESSPOOL
Operation Permit No. 1047-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner MCMAHON, JAMES
Mailing Address 1 P. O. BOX 214
Mailing Address 2
City St Zip NEW SUFFOLK NY 11956-,0000
Property Address 1 450 FREEMAN ROAD
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-9538
Tax Map No. section 139.00 block 3 lot 39.000
Cross Street GRAND AVENUE
Date Of Last Pump Out 0/00/00
Issue Date: 3/15/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
•
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OFFICE OF THE TOWN CLERK rxtFFp� '-
Town of Southold. % C°O - Application No. 6 4"2
Judith T. Terry, Town Clerk . �� ��� Residential
Town Hall, 53095 Main Roads'
P. 0. Box 1179 cry �; fi
- � z Non-Residential
Southold, New York 11971 OrO.�•�`�
Telephone -ioj •
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE 3//3/cff
OWNER NAME: jainfAc it i h&
OWNER MAILING ADDRESS: , O__ ,& 02 /47
/Val 5C) �. ' / //fri // 'o7
OWNER PROPERTY ADDRESS: 4 5O , rn 7 _
,/,774,Z.eaeAr N //93--
OWNER TELEPHONE NUMBER: c.2f, fr3F
TAX MAP NO. : Section /3 9 Block q 3 Lot 3g
CROSS STREET: cielg„,73,9-4) 40.e1. 6-Raturd
TYPE OF SYSTEM: Septic Tank New Existing 1/
Cesspool New Existing 1/
Residential V Non-Residential
DATE OF PREVIOUS PUMP-OUT: /7Pe-
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: -
. Town Clerk's Office
DATE: 0
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