HomeMy WebLinkAboutSaunders (2) OFFICE OF THE TOWN CLERK ' ,c3VFFO(r ,'
Town of Southold , COG
5,1
Judith T. Terry, Town Clerk
Town Hall, 53095 Main RoadP. O. Box 1179 v'
Southold, New York 11971 ;0 ��',
Telephone ! [ �� `�
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. NR 5 Residential
Fee $ 25.00 Non-Residential XX
Septic Cesspool XX -_
NAME OF OWNER; Sophie T. Saunders
OWNER MAILING ADDRESS: P.O. Box 134
Laurel, New York 11948
OWNER PROPERTY ADDRESS: Franklinville Road
Laurel, New York
OWNER TELEPHONE NUMBER: 516-298-4838 •
TAX MAP NO. : Section 125 Block ! .2 Lot 4. 1
CROSS STREET: Elijahs Lane
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool XX New Existing xx
Residential Non-Residential xx
DATE OF PREVIOUS PUMP-OUT: 7-21-86
•
Ju ith T. Terr
Southold Town C erk
DATE: August 22, 1986 /
• � l
(TOWN' SEAL) ;
OFFICE OF THE TOWN CLERK ocvFFDCA-
Town of Southold �o _ CQG Application No.4//2 s`
Judith T. Terry, Town Clerk -
Town Hall, 53095 Main Road } Residential
P. O. Box 1179X ��:' Non-Residential yd
Southold, New York 11971 O 4...
Telephone Nh
p •
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. ,/.2,e
Fee $
DATE g —
� n�
OWNER NAME: Se,f)///_.h" / ' $/ 'A47,47p 5
OWNER MAILING ADDRESS: /''' //" /L 1 34'
999, A7 ABY' 17/1%
OWNER PROPERTY ADDRESS: piu- �/"o /p v A49. / L
OWNER TELEPHONE NUMBER: 57z-- 1.0Z7'
I
TAX MAP NO. : Section / � � Block �. Lot /72/ /
CROSS STREET: ` /fg//� //t7,
,
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing X
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.)
IchlttR -G't.0 ''\J vi-
Sig nature of Applicant
RECEIVED B Y: ,Y(..,,-)( 06,4.— �e��r —
Town Clerk%' Office U
DATE: _< r �� a? /9 c
_s
/'1---4 ,-;.%' ma-z-5
,/?xg .#/'tc TMJ, C,k cs.147 0.L.
.28 /5 to
5-0
.r
I I
I
/7o
r
- ON Kyi �
50/2/1/1� 77 sfiliivp e15�, Z
11DP,A1Tr" 0 WA/j;-:A'S A I n.11 I: /
5Fc7 /aN , 1.25 1320c ,k'. f -2 2DT. 4