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HomeMy WebLinkAboutSchloth OFFICE OF THE TOWN CLERK Town of Southold Judith T. Terry, Town Clerk s� Town Hall, 53095 Main Road P'. O. Box 1179 a, 'r:: w:`lk Southold, New York 11971 Ot�Q‘• - J Telephone = 44, -.11;0‘ (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 107 Residential X • Fee $ 10.00 Non-Residential Septic Cesspool X NAME OF OWNER: Cornelius and Arlene Schloth OWNER MAILING ADDRESS: 595 Tuckers Lane Southold, New York 11971 OWNER PROPERTY ADDRESS: 595 Tuckers Lane Southold, New York OWNER TELEPHONE NUMBER: 516-765-3873 TAX MAP NO. : Section 59 Block 11 Lot 4 CROSS STREET: Between Griswald and Glover Streets TYPE OF SYSTEM: Septic Tank New Existing Cesspool X New Existing x Residential X Non-Residential DATE OF PREVIOUS PUMP-OUT: Unknown eOIX'ee2;;e:--.01 Judith T. Terr Southold Town erk DATE: October 22, 1986 (TOWN SEAL) - OFFICE OF THE TOWN CLERK FtO( r�" Town of Southold ' Application No./0 yG Judith T. Terry, Town Clerk ) Residential v Town Hall, 53095 Main Road P. O. Box 1179 cry c 4 { � ► .`' Non-Residential Southold, New York 11971 O�� 'j; Telephone _ 1 JINIg ' (516) 765-1801 TOWN OF SOUTHOLD RECEEVPD OCT 22 SOUTHOLD WASTEWATER DISPOSAL DISTRICT X986 T"'""' Nrfr Southold APPLICATION for 4, OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No./0 7 Fee $ /( °25 DATE /0V/7l�-( OWNER NAME: C�/P.Aie:Xi,JS '9''b sGyhoTh' OWNER MAILING ADDRESS: .6-9 7-Ate,i"F,QS ,. ,941E so Two /2/ y: /! q°7/ OWNER PROPERTY ADDRESS: .5-09-' OWNER TELEPHONE NUMBER: 766= .3,,F73 TAX MAP NO. : Section 5-9 Block /1 Lot `T CROSS STREET: C3FTw, EA, &eisW 44.D aitl,6 G.4ouF_ , - 77re 73 TYPE OF SYSTEM: Septic Tank New Existing Cesspool New Existing Residential Non-Residential DATE OF PREVIOUS PUMP-OUT: 114' 'O w aJ 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.) Signat/w e of Applicant RECEIVED BY: Town Clerk's Office • DATE: �l_-I.Le,CJ o202, / L MEMORANDUM , Date /b//7f 6 To Q/ 1'CL © To evii.) CA E.-121 7 U/A10 9o77/6e- su3.7Z T: .(OC,4T/oN i9 • :,- - . - - - -,,(_- 7i✓G���2s /9,yF scuteyo,c) A1 tn /{D uSE(5-Q0 H10° 1 • I I ‘aso' I NoQrH cyg° ftE. 1 1 C, J SCH LOTH SCIN sz(2-76) 595 TUCKERS LANE E 56-128 9/85 SOUTHOLD° Net:_111971'