HomeMy WebLinkAboutSalter OFFICE OF THE TOWN CLERK • •cOFUUrt)l/
Town of Southold 4 $
Judith T. Terry, Town Clerk % . z- ftr
Town
. z-Town Hall, 53095 Main Road - '
P. O. Box 1179
Southold, New York 11971 0 ®' .�. '*ON•�••
Telephone ��
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 133 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool g
NAME OF OWNER: Stanley J. Salter
OWNER MAILING ADDRESS: 440 Cases Lane
Cutchogue, New York 11935
OWNER PROPERTY ADDRESS: 440 Cases Lane
Cutchogue, New York
OWNER TELEPHONE NUMBER: 5164734-6982
TAX MAP NO. : Section 109 Block 5 Lot 7
CROSS STREET: Main Road, State Route 25
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing x
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: Unknown
Judith T. Terr
Southold Town Clerk
DATE: November 7, 1986
(TOWN SEAL) -
SD
OFFICE OF THE TOWN CLERK ioC-AWFUlir
Town of Southold moo'' CQApplication No. /9.--5-
Judith T. Terry, Town Clerk . .�(y•)
Town Hall, 53095 Main Road : _ 7 Residential
P. O. Box 1179 cry ''o. S �;' Non-Residential
Southold, New --York 11971 ‘G‘. *.$
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Telephone (41 * $
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. /3_3
Fee $ IO°%
DATE jiADI./e1bea'- c ,'
OWNER NAME: fTj4-/(///y j 54/1,47
OWNER MAILING ADDRESS:: 4/c/o G4-5es 642
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OWNER PROPERTY ADDRESS: 544/e
OWNER TELEPHONE NUMBER: 7717, fez--
TAX
2f -TAX MAP NO. : Section /d Block L Lot 7
CROSS STREET: i1,$‘/,(7cL K7 5
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool f/ New Existing f,
Residential V- 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.)
I -
ture of Apolicant
RECEIVED BY:
kcf1A v Clerk's Office
DATE: kOV 07 `er;
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