HomeMy WebLinkAboutMaclean rl - 13
OFFICE OF THE TOWN CLERK ' ' FQ
Town of Southold QS� .x COG
Judith T. Terry, Town Clerk % " W � y
Town Hall, 53095 Main Road ,
P. O. Box 1179 stn ' WV.
` x �^ :
Southold, New York 11971 p '$z' '� g��
Telephone .61
311(
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 351 Residential X
Fee $ 10.00 Non-Residential
Septic Cesspool X
NAME OF OWNER: Raymond T. MacLean
OWNER MAILING ADDRESS: 230 Old Shipyard Lane
Southold, New York 11971
OWNER PROPERTY ADDRESS: 230 Old Shipyard Lane
Southold, New York
- OWNER TELEPHONE NUMBER: 516-765-1198
TAX MAP NO. : Section 64 Block 2 Lot 50
CROSS STREET: L'Hommedieux
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing X
Residential X - Non-Residential
DATE OF PREVIOUS PUMP-OUT: Unknown
Judith T. Terry
Southold Town Clerk
- s
DATE: , July "15, 1987
(TOWN SEAL)
r.
ii iii
OFFICE OF THE TOWN CLERK �cOFO r,„'=
Town of Southold �o �Q�';. Application No.-5-Si
Judith T. Terry, Town Clerk �� �" -k' .1./
-*----
Town -� �� ` .G 1 Residential
Town Hall, 53095 Main Road : , O,
to `' t ''
P. O. Box 1179 -4.4,, . Non-Residential
Southold, New York 11971 4 r`
Telephone -9:!/1 44 W.
• (516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ /'- -°
DATE 7/1/#7
OWNER NAME: 6V i/171 /7 Ae ArifitY
OWNER MAILING ADDRESS: 2 -3 42,4--d fifriin,W )4-
Ya b - -_,, /Y /177/
OWNER PROPERTY ADDRESS: V0/L=
OWNER TELEPHONE NUMBER: 96 J v//
ell- z
TAX MAP NO. : Section Block Lot
CROSS STREET: I / 151/11/4-',0/ X
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool i.-----
New Existing !—
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: (7
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.)
a fyi u a z/6 T- Ze,e---4 4(
Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
n
yrbeo ,/y4
X X /%
0