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HomeMy WebLinkAboutBrown ffir Town Hall, 53095 Main Road i. P.O. Box 1179 ,t01 Southold, New York 11971 JUDITH T.TERRY � TELEPHONE "L vir�`"" TOWN CLERK (516) 765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 166-N Residential Non-Residential X Fee $ 25.00 New X Existing Name Of Owner BROWN, ROBERT AND CHRISTA Mailing Address 1 P. O. BOX 2050 Mailing Address 2 City St Zip GREENPORT NY 11944-0000 Property Address 1 MAIN ROAD Property Address 2 City St Zip GREENPORT NY 11944-0000 Owner Telephone No. 516-477-1200 Tax Map No. section 45.00 block 4 lot 6.001 Cross Street MORRES LANE Issue Date: 12/20/96 Judith T. Terry Southold Town Clerk (TOWN SEAL) • •.. OFF'I'CE OF THE TOWN CLERK �c3\\TFD(,r '- Town of Southold � , CQG_� Application o.41?-://:4124 Judith T. Terry, Town Clerk .� "� U'•ti it Town Hall, 53095 Main Road ° x. ; $10.00 - Residential_ - _ P. O. Box 1179 cn s' i �' $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 11 L 94. OWNER NAME: 4E I 4- L.//. OWNER MAILING ADDRESS: 1:::)® Cti Po c-7r OWNER TELEPHONE NUMBER: n - JZOcp TAX MAP NO. : Section /060-44S Block Lot . CROSS STREET: I\A�- t , TYPE OF SYSTEM: Septic Tank New X Existing Cesspool New Existing i Residential Non-Residential _4_ 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.) „4_17,...`a,1,/ MAW -.A ,„6 Applica' RECEIVED BY: 6 / r lo n Clerk's Office DATE: • (_I C to (t i ; . ; • . . ,, , ' .-- -•- .. '• '''''i :92-,:,,'<.r:: ......... 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