HomeMy WebLinkAboutQuinn • OFFICE OF THE TOWN CLERK • •c3IFULk&,"
Town of Southold ���
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road _ 1�
P. 0. Box 1179 ku-s ' y
Southold, New York 11971 O �- •�
Telephone of "Kt I`
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 96 Residential xx
Non-Residential
Fee $ 10.00
Septic Cesspool xx
. NAME OF OWNER: Yolanda S. Quinn
OWNER MAILING ADDRESS: RR2, Box 50B
Southold, New York 11971
OWNER PROPERTY ADDRESS: Bayview Avenue
Southold, New York
OWNER TELEPHONE NUMBER: 516-765-2167
TAX MAP NO. : Section 52 Block 5 Lot 26
CROSS STREET: Colony Road
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool xx New Existing xx
Residential xx Non-Residential
DATE OF PREVIOUS PUMP-OUT: Unknown
Judith T. Terr
Southold Town Clerk
DATE: October 20, 1986
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OFFICE OF THE TOWN CLERK C�S ��= C�/
Town of Southold CQG Application No.9 *
#:41"1-0,Judith T. Terry, Town Clerk � v�.' . tt - Residential
Town Hall, 53095 Main Road c
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P. O. Box 1179 e' ` � ' Non-Residential
Southold, New "York 11971 0 �4 *�`�
Telephone 0I I��� �•
(516) 765-1801
TOWN OF SOUTHOLD
K:FAVED SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OCT 201986
Tow, clerk Southold APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. %
Fee $ /6 -
_
DATE /d --/741
•
OWNER NAME: d/27/1447
OWNER MAILING DDRESS: j , 2. 15oJC 5V3
V4,,,t, , /t/7 1/.9 /
OWNER PROPERTY ADDRESS: /4-0-1.e) Aw
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OWNER TELEPHONE NUMBER: %� 7 X ?-l6P
TAX MAP NO. : Section ,50.2- Block Lot
CROSS STREET: Cr -
TYPE OF SYSTEM: Septic Tank ( New Existing
Cesspool New Existing
Residential X Non-Residential
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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.)
•
Signature of Applicant
RECEIVED BY: c 'x tom_ 26
TownGCierk's office
DATE: I' - j y,F6
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