Loading...
HomeMy WebLinkAboutSchilder 0' JUDITH T.TERRY �� � � Town Hall, 53095 Main Road TOWN CLERK ,sof P.O. Box 1179 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS V®� � ,�� MARRIAGE OFFICER Fax(516) 765-1823�' RECORDS MANAGEMENT OFFICER ° Telephone(516) 765-1800 FREEDOM OF INFORMATION OFFICER - �•�� OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 3722-R Residential X Non-Residential Fee $ 10.00 New Existing X Name Of Owner SCHILDER, STANLEY Mailing Address 1 P. O. BOX 1067 Mailing Address 2 City St Zip MATTITUCK NY 11952-0000 Property Address 1 350 SOUND BEACH DRIVE Property Address 2 City St Zip MATTITUCK NY 11952-0000 Owner Telephone No. 516-298-8792 Tax Map No. section 99.00 block 1 lot 15.001 Cross Street INLET DRIVE Issue Date: 11/12/97 Judith T. Terry Southold Town Clerk (TOWN SEAL) OFFICE. OF THE TOWN CLERK t Town •of SoutholdCQ _� Application No. Judith T. Terry, Town Clerk �� ., , 7: Town Hall4 53095 Main Road 8 -< $10.00 - Residential P. O. Box 1179 cn # •<<' ;` $25.00 - Non-Residential Southold, New York 11971 Telephone _ 144 11 0 (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ q � DATE D0� , (Q\ L" ` c / OWNER NAME: SidNL Lf Cbt( LDifa OWNER MAILING ADDRESS: Z©- epax Lz) (Di OWNER PROPERTY ADDRESS :'3S0 ° r �� a V tvc prc—c(-tvcA-z cab `t'379 OWNER TELEPHONE NUMBER: Std' TAX MAP NO. : Section °\( °\. Block Lot I CROSS STREET: Hot, TYPE OF SYSTEM: Septic Tank New Existing / Cesspool V New Existing V Residential V Non-Residential 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.) APIA,•4 �i a v a. Signatu e of Applicant ilkRECEIVED BY: drown Clerk's Office DATE: /7// -�-1 '40r7° '' i 1 / y �1«'1 .,,,,,,..rt.....:.,- k00:39 4 ' � 051 � V _. -_Ai:-• - NAS r-6 e k i rie ,: d + b i r V • 0,1 , / • .71 / . STANLEY =p- ALMA SCH LDE . 1 ST 5 ; S9 E 0 n1 0 - r` l I Li.) A;/ f 4 s1 in - - ± MAT_�.,. F'u bpd 1 € a ~-i-L.J gym: 1�1 J - -, f J -I -"TCY,�i 5" S:3.,.:rc-101._ Cil.'! i 1 ►J�i, [i L - 1 - O -es - - • _ A• � z • 10 l • , i \ J 1 I �� 1 �eY+ , ' i l2fo,f0 Eo we. -}• �ofc• ; 1_0+ !-fU1.4-1CJc�'/3 '%rtC.,Wr1 Y i c.,'.v '4'=a�a O o� --- - = t _-- f9�u„ of 1Miai• DV. CU sT:trrr iCic ci C=E1 t� Ti:':: j d1 ,eU 'of k Sul-4. S. -- - . Y0 W. C �, � '.. ..._./ A- - - - Colt�tic. Clvlc'� pe iLc c: til=' T• StaTa, ��7eN•cE -a SOt.i%ii ` '' ll LL ! (�� L G arcxrj-'ce d +o4 -t M 11-!-re_ Cow---r....�)UaikL. ti' Ems. - t- V I'� LJ C" LJ �4.. v'.4;.X Y c C•• �-iM L5 Y * ` . U J %c.1 r+s :0`r,ti ._)'c, V A11.1 -.1 L_'4'L h' . [:•:,; '''4'2727 r.>: .,,,.e a�• _ /