HomeMy WebLinkAboutRichter OFFICE OF THE TOWN CLERK •c�VFFD(K
Town of Southold N� ?
Town Clerk CDG
Judith T. Terry,
Town Hall, 53095 Main Roadj ,
P. O. Box 1179 v'
Southold, New York 11971
Telephone
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(516) 765-1801
•
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 42 Residential x
Non-Residential
Fee $ 10.00
Septic Cesspool xx
NAME OF OWNER: Ernest F. Richter
OWNER MAILING ADDRESS: 705 Front Street
Greenport, New York 11944
• OWNER PROPERTY ADDRESS: 705 Front Street
Greenport, New York
OWNER TELEPHONE NUMBER: 516-477-0443
TAX MAP NO. : Section 48 Block 1 Lot 11
CROSS STREET: Seventh Street
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool xx New Existing XX
Residential XX Non-Residential
- DATE OF PREVIOUS PUMP-OUT: JUly 1986
•
Ju it 'T. err
Southold Town C erk
DATE: September 11, 1986
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(TOWN SEAL) )
OFFICE OF THE TOWN CLERK cvFFOC,(I�'-
Town of Southold _ CQt Application No. p-
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road `. : :'� Residential
P. O. Box 1179 to �` Non-Residential
Southold, New York 11971 -' v
Telephone ®.( NN
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ / ' 2
DATE 9///4'
OWNER NAME: ,&e/11�eSj
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS: 7 y F---/e /1"7" ter%
//7Z1
OWNER TELEPHONE NUMBER: -X77-
TAX MAP NO. : Section p1,9 Block / Lot AA.
CROSS STREET:
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing ,Y
Residential / Non-Residential
DATE OF PREVIOUS PUMP-OUT: 7cn,
• 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: pi A, �_ I, C� •�
Town Cie/ 's Offi
DATE:
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