HomeMy WebLinkAboutFinne CT•
OFFICE OF THE TOWN CLERK
Town of Southold
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 11971
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 14 Residential X
Fee $ 10 . 00 Non-Residential
Septic Cesspool X
NAME OF OWNER: Chester P . Finne Sr.
OWNER MAILING ADDRESS: 137 Boisseau Avenue
Southold, NY 11971
OWNER PROPERTY ADDRESS: 2670 Boisseau Avenue
Southold, NY 11971
OWNER TELEPHONE NUMBER: 765-2789
TAX MAP NO. : Section 55 Block 6 Lot 11
CROSS STREET: Main Road
- TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing X
Residential X Non-Residential -
DATE OF PREVIOUS PUMP-OUT:
Judith T. Terr
Southold Town Clerk
DATE: August 18, 1986
�
rr
I "
\‘, (TOWjN SEAL)
I
a.
OFFICE OF THE TOWN CLERK �FFD '
Town of Southold ®�o�. 'r•: 4 - • Application No.
Judith T. Terry, Town Clerk `s `` `'
' i Residential , /
Town Hall, 53095 Main Road o - I/
P. O. Box 1179 u' f* fr; Non-Residential
Southold, New York 11971 ® r
Telephone
(516) 765-1801 d
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. /,1 •
Fee $ /O •°y"
DATE 0,PA
OWNER NAME: CFSf P fle )
OWNER MAILING ADDRESS: 13 L la(j �}
OWNER PROPERTY ADDRESS: C -f%ES' 4,-,le___,/:7/':;t/�j� t'k
�Sr ,r-e /vae/se-Xi:I Kre .76?)
OWNER TELEPHONE NUMBER: - e7e
TAX MAP NO. : Section a Block Lot //
CROSS STREET: IJ
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool V New Existing r/
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.)
Signature of Applicant
RECEIVED BY: gtcCc,-
Town Jerk's ffice
DATE: J r< / 2 Ob
1
(
/ems
4Y's
5