HomeMy WebLinkAboutGowen OFFICE OF THE TOWN CLERK w�\��e'(/i('`,O
Town of Southold , �� G
Judith T. Terry, Town Clerk ` �1 _
Town Hall, 53095 Main Road
P. O. Box 1179 crl P
Southold, New York 11971 ti O ®" R Nr. '�
Telephone 1 Alt w
(516) 765-1801 -- — `
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT -
SEPTIC TANK or CESSPOOL
Operation Permit No. 204 Residential X
Non-Residential
Fee $ 10.00
Septic x Cesspool x
NAME OF OWNER: Rosalie Gowen
OWNER MAILING ADDRESS: 1495 Central Drive, Box 225D
Mattituck, New York 11952
OWNER PROPERTY ADDRESS: 1495 Central Drive, Box 225D
Mattituck, New York 11952
OWNER TELEPHONE NUMBER: 516-298-9196 _
TAX MAP NO. : Section 106 Block 2Lot 32 and pLo 43
CROSS STREET: Zena Drive
TYPE OF SYSTEM: Septic Tank X New Existing x
Cesspool X New Existing x
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: September 18, 1976
401r(411.1.;X31..
Judith T. Ter
Southold Town Clerk
DATE: January 23, 1987
•
(TOWN; SEAL),
/e '
OFFICE OF THE TOWN CLERK C,�t•FZeCQ',
Town of Southold1. _ Application No. a /J
Judith T. Terry, Town Clerk y� ��' 1
�.�. �.C‘I Residential t�
Town Hall, 53095 Main Road -;:44 -
P
4 ` -
P. 0. Box 1179 cr304 4 : Non-Residential
Southold, New York 11971
Telephone 0 "
(516) 765-1801
TOWN OF SOUTHOLD
RECEffqo
JAN ®g 1981 SOUTHOLD WASTEWATER DISPOSAL DISTRICT
Town Clerk Southold
APPLICATION
for
OPERAT ION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.91 O '7"
Fee $ /6, D1
•
DATE J/M;
OWNER NAME: ROSALIE GOWEN
1495 CENTRAL DR BOX 2251
OWNER MAILING ADDRESS: MATTITUCK,NY11952 1111k '
OWNER PROPERTY ADDRESS:
OWNER TELEPHONE NUMBER: 95P- 9/f6
TAX MAP NO. : Section /Oco Block Lot 3�-
CROSS STREET:-�Ei✓A- eft'•
TYPE OF SYSTEM: Septic Tank }/ New f/ r/ 3 Existing
Cesspool New 073 Existing
Residential ,/ Non-Residential
DATE OF PREVIOUS PUMP-OUT: 9 ! / P/74-
LOCATION
x'/74LOCATION 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.)
irA" Signature of Applicant
RECEIVED BY: .
62Fciffi " Crk's Of ice
DATE: J N 23 1987
Town Clerk Southold
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-ed 2.5`..e , t�f. 86".2 0.'41 0-1,�. to this survey iso violation of
Section 7209 of the New York State
Education Law. -
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CA Pr: Z lj">Q D, f S/ Copies of this survey map not hawingg
- the land surveyor's inked seal or
embossed seal shall not be considered
jto be a valid true copy.
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__ _ _ _.____^ Guarantees intlicsted hereon shell run •
= — only to the person for whom the survey
\� •fi/ is prepared.and on his behalf to the
title company,Boesrnmentsl agency end
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landing institution listed hereon and
to the assignees of the lending ind-
• - ; tution.Guarantees are not transferable
}" r to additional institutions or subsequent
I' _...�___..__._._._.--.T...._ .__ _� __-____..__.__ _______-__________._.-___ ._____ __� owners ---____- _. _____ .__-__—•---- __—_._-_—