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B ' ' Town Hall, 53095 Main Road
® \� P.O. Box 1179
/® ! �`�for Southold, New York 11971
JUDITH T.TERRY TELEPHONE
TOWN CLERK (516)765-1801
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. 747-R Residential X Non-Residential
Fee $ 10. 00 Septic Cesspool X
New Existing X
Name Of Owner GETCHES, JOSEPH
Mailing Address 1 BOX 51
Mailing Address 2
City St Zip ORIENT NY 11957-0000
Property Address 1 385 OYSTERPOND LANE
Property Address 2
City St Zip ORIENT NY 11957-0000
Owner Telephone No. 516-323-2403
Tax Map No. section 25. 00 block 1 lot 6. 000
Cross Street ROUTE 25
Date Of' Last Pump Out 0/00/83
Issue Date: 6/29/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
-
OFFICE OF THE TOWN CLERK c3VFFO(,( -
Town of Southold �� CQ Application No.77'//
7
Judith T. Terry, Town Clerk gyY� �►
Town Hall, 53095 Main Road
Residential
P. O. Box 1179 cry ` , VMT,? i z Non-Residential
Southold, New York 11971 ®r �0 ��`
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. r.) �
Fee $ `O,. CO
DATE
OWNER NAME: t) 05 pJ-) G F7'C J-1E 5
OWNER MAILING ADDRESS: BOX Si) ORIJNT, ,Vy ,1/957
OWNER PROPERTY ADDRESS: 3 g's OyST R PoNP LAI N5
OWNER TELEPHONE NUMBER: :•73 -29-03
TAX MAP NO. : Section p9S Block ( Lot c-1-7
CROSS STREET: 21`_ ,�""
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing 7
•
Residential r/ Non-Residential
DATE OF PREVIOUS PUMP-OUT: /cg13
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: 1p /
k?€cEiTown Clerk's Office
DATE: mJii 2 9 119118
Town Me* Sulithatt