HomeMy WebLinkAboutMacnish OFFICE OF THE TOWN CLERK c0FUL
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Town of Southold
Judith T. Terry, Town Clerk =y
Town Hall, 53095 Main Road V g
P. 0. Box 1179 i v� '
Southold, New York 11971 r*: �
Telephone 201 +�
(516) 765-1801 11 •
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 526 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool X
NAME OF OWNER: Helen MacNish
OWNER MAILING ADDRESS: P.O. Box 492
Southold, New YOrk 11971
OWNER PROPERTY ADDRESS: 2750 Pine Neck Road
Southold, New York 11971
OWNER TELEPHONE NUMBER: 516-765-3017
TAX MAP NO. : Section 70 Block 10 Lot 3
CROSS STREET: Oaklawn Avenue
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing x
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: Unknown
Judith T. T ry
Southold Town Clerk
DATE: December 10, 1987
•
(TOWN SEAL)
OFFICE OF THE TOWN CLERK .0VFFU(,- -
Town of Southold �� i, CQ ' , Application No. 6
Judith T. Terry, Town Clerk f, • ;
Town Hall, 53095 Main Road . o w r4. Residential
P. O. Box 1179 crs � - �- '^"�''
�` Non-Residential
Southold, New York 11971 O ' �, �•`
Telephone _0 '•
ge
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
tor
OPERATION PERMIT
SEPTIC TANK or. CESSPOOL
Operation Permit No.
Fee $ ! G 16
DATE f- J®/e7
OWNER NAME: I!t -• V6'l.
OWNER MAILING ADDRESS: 11)R Qr O X Lf 9 2
e-ue,4:IQs� `\01 ( H 9 7/
OWNER PROPERTY ADDRESS:
3 -0.--e.c2;k4"—e -)ifg. , / ( r7
OWNER TELEPHONE NUMBER: 76 3 c f 7
TAX MAP NO. : Section ,7v Block /v Lot
CROSS STREET: Oa-k!, ecw/r/Ave/via e,
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing x
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT:
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.)
A7z-e-eLlTh
Signature of Applicant
RECEIVED Y n at-e )
Town � erk's ffice
DATE: DEC 1 ® 1961
Town Clerk SouthOld
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