HomeMy WebLinkAboutReedJUDITH T. TERRY
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1800
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3462-R Residential X Non -Residential
Fee $ 10.00 New X Existing
Name Of Owner REED, MICHAEL AND VICKI
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Mailing Address 1 C/O 27 TIDE CT
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Mailing Address 2
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City St Zip WADING RIVER NY 11792-1053
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Property Address 1 220 SELAH LANE
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Property Address 2
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City St Zip MATTITUCK NY 11952-0000
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Owner Telephone No. 516-298-8843
Tax Map No. section 106.00 block 9 lot 4.007
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Cross Street COX NECK ROAD
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Issue Date: 5/16/96 Judith T. Terry
-------- Southold Town Clerk
(TOWN SEAL)
OFFljCE OF THE TOWN CLERK
Town of Southold
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road
P. 0. Box 1179
Southold, New York 11971
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
Application No.13 q(Po?l
$10.00 - Residential
$25.00 - Non -Residential
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. _5q(,, -2--
Fee
Fee $ /,0, 0 O
DATE_ :Z166IY4
OWNER NAME: N101-1,4'CL /04-Y j('
OWNER MAILING ADDRESS: .22b SL Lill yG
OWNER PROPERTY ADDRESS: o2- 020 /0s3
OWNER TELEPHONE NUMBER:�j�
TAX MAP NO.: Section /0 6 Block Lot //V/
CROSS STREET:
TYPE OF SYSTEM: Septic Tank New_Existing
Cesspool Newy Existing
Residential 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.)
Signatur6 of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
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