HomeMy WebLinkAboutTeds Auto Body OFFICE OF THE TOWN CLERK • •c0FOUr
Town of Southold
Judith T. Terry, Town Clerk Z k7;
Town Hall, 53095 Main Road
P. 0. Box 1179
Southold, New York 11971 -
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Telephone 't' •
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. NR37 Residential
Fee $ 25.00 Non-Residential X
Septic Cesspool X
NAME OF OWNER: Teds Auto Body Inc. - Frank Klos and RnhPrt Klns
OWNER MAILING ADDRESS: Main Road
Peconic, New York 11958
OWNER PROPERTY ADDRESS: Main Road . .-
Peconic, New York 11958
OWNER TELEPHONE NUMBER: 516-734-5297
TAX MAP NO. : Section 85 Block 3 Lot 6 c` ✓ J
CROSS STREET: Skunk Lane, Cutchogue
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing X
Residential Non-Residential X
DATE OF PREVIOUS PUMP-OUT: January 1987
Judith T. Terry
Southold Town Clerk
DATE: April 22, 1987
(TOWN SEAL)
OFFICE 'Of THE TOWN CLERK CS Fair
Town of Southold ea-- Application No/Vie 3 7
Judith T. Terry, Town Clerk 4
Town Hall, 53095 Main Road A: Residential
P. O. Box 1179 (
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1 _ � i�;' Non-Residential
Southold, New York 11971 4 y .O�•�`
Telephone ®.( y �� '.
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(516) 765-1801
TOWN OF SOUTHOLD
IZE IVSD
APR 0 8 1987 SOUTHOLD WASTEWATER DISPOSAL DISTRICT
Town Clerk Southold APPLICATION
for -
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE co
OWNER NAME: /71-4,), }-.)/,o s ter(' Kilos j s 10jo �3ody
OWNER MAILING ADDRESS: M
act-1)N 4c I\l •1
OWNER PROPERTY ADDRESS: IA {4 ►nr
OWNER TELEPHONE NUMBER: 576 - 73 y- -5-g9 `7
TAX MAP NO. : Section (j 13 5 Block 3 Lot c z P p C
CROSS STREET: 5/� � � Jc l•« . CvrtcL. u Irl li-
TYPE OF SYSTEM: Septic Tank New Existing '
•
Cesspool New Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT:' w,,� , 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.)
Signature of Applicant
RECEIVE :M*
Town Clerk's Office
APR 2 21987,
DATE:
Town Clerk Southold
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