HomeMy WebLinkAboutHeaney (2) Town Hall, 53095 Main Road
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e�. .1' P.O. Box 1179
_ n '�� Southold, New York 11971
JUDITH T.TERRY --�..~�i.��0's', TELEPHONE
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. 69-N Residential Non-Residential X
Fee $ 25. 00 Septic Cesspool X
New Existing X
Name Of Owner HEANEY, ROBERT J.
Mailing Address 1 BOX 196
Mailing Address 2
City St Zip GREENPORT NY 11944-0000
Property Address 1 SKIPPERS RESTAURANT
Property Address 2 ROUTE 25
City St Zip GREENPORT NY 11944-0000
Owner Telephone No. 516-477-2242
Tax Map No. section 35. 00 block 2 lot 8. 000
Cross Street MAPLE LANE
Date Of Last Pump Out 0/00/00
Issue Date: 5/23/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK ���FQ(�.
Town of Southold CQG'_. Application No./116?
Judith T. Terry, Town Clerk �% 1 ._
Town Hall, 53095 Main Road c ' Residential
P. O. Box 1179 cry
�i .� �t ��� Non-Residential
`..r
Southold, New York 11971 ®�® +- .,�0� ��
Telephone °�
. l_(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. NR C
Fee $ p %
DATE c /,5 gg
OWNER NAME: 2ERT .-Api y
OWNER MAILING ADDRESS: Z,,V. >/C A /J
g A1,,,M i Ai,7= 1l q V
OWNER PROPERTY ADDRESS: 1k /PP. ',�P$ / ( , ,9L /7
/FT: g gAiPOleT Aitiy
OWNER TELEPHONE NUMBER: 5/ 77—
TAX
/ 77--TAX MAP NO. : Section 35 Block Lot
CROSS STREET: / JoA G .41. g T Q;j—
TYPE OF SYSTEM: Septic Tank X New Existing
Cesspool x New Existing
Residential Non-Residential
-- DATE OF PREVIOUS PUMP-OUT: 7/2,
LOCA ION 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.)
ab
tPPer
Signatur_- App icant
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RECEIVED BY: c ' c,
TownIerk's Of ice
DATE:
MAY 2 3 1988
Ion cot Southold