HomeMy WebLinkAboutManeral OFFICE OF THE TOWN CLERK p
Town of Southold Gam'
Judith T. Terry, Town Clerk Zt ,
Town Hall 53095 Main Road }`
P. 0. Box 1179 '079
Southold, New York 11971 Q °'® '` _ '
Telephone _ !
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 537 Residential x
Non-Residential
Fee $ 10.00
Septic Cesspool x
NAME OF OWNER: Viola Maneral
OWNER MAILING ADDRESS: 2500 Harbor Lane
Cutchogue, New York 11935
OWNER PROPERTY ADDRESS: 2500 Harbor Lane
Cutchogue, New York
OWNER TELEPHONE NUMBER: 516-734-6991
TAX MAP NO. : Section 103 Block 1 Lot 30
CROSS STREET: Pierce Drive
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=/'y
Southold Town Clerk
DATE: December 14. 1987
(TOWN SEAL)
• iii
OFFICE OF THE TOWN CLERK SOFjJ .- .
Town of Southold �® CQG Application No. 6"37
Judith T. Terry' Town Clerk
0
Town Hall, 53095 Main Road c `f. ;rt,. -
Residential
P. O. Box 1179 �. �-:�: �
„� � '�� Non-Residential
Southold, New York 11971
Telephone 0
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.s9
Fee $ /o
DATE 40/./.7
1;.-eet...;OWNER NAME: i
OWNER MAILING ADDRESS: oZ�� D,
y,
OWNER PROPERTY ADDRESS:
OWNER TELEPHONE NUMBER: 7J - X99/
TAX MAP NO. : Section /6 ,3 Block / Lot
CROSS STREET:
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool / New Existing V
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.)
Signature of Applicant
RECEIVED BY: .ce )
Townrk's O fice
RECEIVED
DATE: DEC 141937
Town Cie( Southold