HomeMy WebLinkAboutMcnamee OFFeeir
JUDITH T.TERRY `�is a Town Hall, 53095 Main Road
TOWN CLERK cgg, g s P.O.Box 1179
REGISTRAR OF VITAL STATISTICS o �� Southold,New York 11971
MARRIAGE OFFICER Fax(516)765-1823
RECORDS MANAGEMENT OFFICER .: ®1 010 Telephone Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER �,,
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3293-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner MCNAMEE, JAMES T.
Mailing Address 1 945 THREE WATERS LANE
Mailing Address 2
City St Zip ORIENT NY 11957-0000
Property Address 1 945 THREE WATER LANE
Property Address 2
City St Zip ORIENT NY 11957-0000
Owner Telephone No. 516-323-1349
Tax Map No. section 15.00 block 6 lot 15.000
Cross Street NORTH SEA DRIVE
Issue Date: 12/12/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
A'
sea
. OFFICE OF THE TOWN CLERK S�FFO�
Town of Southold �® CQG=� Application No. .19,4
Judith T. Terry, Town Clerk �� =' ``l $10.00 - Residential
Town Hall, 53095 Main Road
P. O. Box 1179 cn $25.00 - Non-Residential
Southold, New York 11971 ' ` ��`�
Telephone
(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: k, / ,
OWNER MAILING ADDRESS: 9V1 —1.2/a,0 60l9 reA, .1- Af-
e AJ) . //9f'l
OWNER PROPERTY ADDRESS : qy1 //2i L% /u'' ,&,z2
0 A f/7-- y, jK717
OWNER TELEPHONE NUMBER: 2;2.3 - 13 '19'
TAX MAP NO. : Section /5"-
Block 6 Lot /6
CROSS STREET: JVzA✓4' 5,k-S9 / iP
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool 7`- New Existing
Residential X Non-Residential
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.)
" .4eL- - -
Signature of Ap.licant
RECEIVED BY: ht./ AL,C-A-71e
Town Clerk's Office
DATE: / �`/ Jz/9
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