HomeMy WebLinkAboutGrattan 7 • A®
JUDITHAtf
T. TERRY
Town Hall, 53095 Main Road
�. � �
TOWN CLERK P O. Box 1179
REGISTRAR OF VITAL STATISTICS �' Southold, New York 11971
MARRIAGE OFFICER Fax (516) 765-1823
= e• ' Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 1761-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner GRATTAN, GEORGE AND JOYCE
Mailing Address 1 BOX 984
Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
Property Address 1 895 VILLAGE LANE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-4690
Tax Map No. section 114.00 block 6 lot 11 .000
Cross Street MAIN ROAD
Date Of Last Pump Out 0/00/87
Issue Date: 9/20/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
,7&(
OFFICE OF THE TOWN CLERK • /�/�(Q"/�
Town of Southold �� ; CQG' Application No.
Judith T. Terry, Town Clerk i y
Town Hall, 53095 Main Road -� $10.00 - Residential
P. O. Box 1179crs ;t` � $25.00 - Non-Residential
Southold, New York 11971 O o- _= -}
Telephone : l- y► .
•
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
' - for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE Syr: if'/(77/
OWNER NAME: Getyrj g a- —Jpyce,— G rrn4
OWNER MAILING ADDRESS: AA 99q
Ynci,r177i , IlY ►t1
-- - OWNER- PROPERTY ADDRESS: Vi-//13e, n -
rTiTucL) /IBJ
OWNER TELEPHONE NUMBER: a7F'1/6gp
TAX MAP NO. : Section Vo iIQ5e, 14tr Block Vii e)-02,34 e- Lot G
ss
CROSS STREET: c41/n A° •
TYPE OF SYSTEM: Septic Tank New Existing - t/
Cesspool New Existing
Residential Non-Residential
7 traws & s
DATE OF PREVIOUS PUMP-OUT:
7k45 o-ne done- rm 4-ej 197/ - � v
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.)
Signatur!of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
RECEIVED
SEP 19 1981 -
T iwn Clerk Southold -