HomeMy WebLinkAboutNolan lit
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Town Hall, 53095 Main Road
P.O. Box 1179
'__ ®� ro's Southold, New York 11971
JUDITH T.TERRY FAX(516)765-1823
TELEPHONE(516)765-1801
TOWN CLERK
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. 89-N Residential Non-Residential X
Fee $ 25.00 Septic Cesspool X
New Existing X
Name Of Owner NOLAN, JOSEPH E. AND ANNE T.
Mailing Address 1 685 ORCHARD STREET
Mailing Address 2
City St Zip NEW SUFFOLK NY 11956-0000
Property Address 1 MAIN ROAD
Property Address 2
City St Zip CUTCHOGUE NY 11935-0000
Owner Telephone No. 516-734-5479
Tax Map No. section 102.00 block 6 lot 8.000
Cross Street NEW SUFFOLK LANE
Date Of Last Pump Out 0/00/00
Issue Date: 5/16/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK •cSFOur��'•
Town of Southold CQ ' Application No.N',
9
Judith T. Terry, Town Clerk ',
•
Town Hall, 53095 Main Road a ''kf= :' Residential
ri-*
`P. O. Box 1179 u' � ��� Non-Residential � ; _Southold, New York 11971 'l '
Telephone .(
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No-1 ,
Fee $
DATE /(3/ 17
OWNER NAME: It S Vff- pC AcWe 1, /(4k
OWNER MAILING ADDRESS: 0s (9e ?'iw rT
OWNER PROPERTY ADDRESS : J//7 4'i 7€d
CeTC6- a a ��
OWNER TELEPHONE NUMBER: ST 7,3 ( -5L'7
TAX MAP NO. : Section ' 8 2 Block Lot g r 7
CROSS STREET: tVt (/( RID, kiet,usue Pic)L-c< /x(,
TYPE OF SYSTEM: Septic Tank ✓ New Existing e/
Cesspool New Existing
• Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: 1.a- • I
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:
Town Clerk's Office •
DATE:
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