HomeMy WebLinkAboutFeeney OFFICE OF THE TOWN CLERK • S�FFOLkC'
Town of Southold ,Q �lj
Judith T. Terry, Town Clerk �� - . y
Town Hall, 53095 Main Road a 0.. r
P. O. Box 1179 to �\
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Southold, New York 11971 p '' '" �••
Telephone �l 41(
(516) 765-1801r
TOWN OF SOUTHOLD
SOUTHO—D-WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 380 Residential X
Non-Residential
Fee $ 10.00 -
Septic Cesspool X
NAME OF OWNER: John R. Feeney
OWNER MAILING ADDRESS: 495 Siqsbee Road
Mattituck, New York 11952
OWNER PROPERTY ADDRESS: 495 Sigsbee Road
Mattituck, New York
OWNER TELEPHONE NUMBER: 516-298-4502
TAX MAP NO. : Section 143 Block 2 Lot 9
CROSS STREET: Main Road and Peconic Bay Blvd.
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: March 30, 1987
Judith Te
Southold Town Clerk
DATE: August 3, ;1987
•
(TOWN SEAL)
OFFICE OF THE TOWN CLERK CS HU(
Town of Southold
®�®0-444
Application No. ��
Judith T. Terry, Town Clerk SY
" 'f. I Residential
Town Hall, 53095 Main Road c n;, -
P. 0. Box 1179 u-' � 'k' �� Non-Residential
Southold, New York 11971 O ®
Telephone _®1 lag ' .'
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3r
e
Fee $ / 12
DATE
V'17
OWNER NAME: 1 O/Jc/ ,. 7E417-1/
OWNER MAILING ADDRESS: g--96- �1i /744
o
OWNER PROPERTY ADDRESS: N,Y4
OWNER TELEPHONE NUMBER: 74—
TAX MAP NO. : Section / 9 Block Lot J
CROSS STREET: /f,/4/ J ' / )? 72- e cJ/�/ G Bi /
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing t�
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: ! ��� j 1,1 /717
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 or
doielr
RECEIVED BY: •
MEM* own ferk's Of ice
DATE: N1G031987
Town Clerk Southold
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