HomeMy WebLinkAboutReeveOFFICE 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
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 481 Residential X
Fee $ 10.00 Non -Residential
~• Septic Cesspool X
S NAME OF OWNER: Alicia Reeve
OWNER MAILING ADDRESS: 1475 Suffolk Avenue, P.O. Box 1157
Mattituck, New York 11952
^J4 3
OWNER PROPERTY ADDRESS: 1235 Suffolk Avenue
Mattituck, New York
OWNER TELEPHONE NUMBER: 516-298-8371
TAX MAP NO.: Section 114 Block 11 Lot 25
CROSS STREET
TYPE OF SYSTEM:
Septic Tank
Reeve Avenue
New
Cesspool X New
Residential X
DATE OF PREVIOUS PUMP -OUT: NA
DATE: November 9, 1987
X
Existing
Existing
Non -Residential
Igor-
Judith T. -Wrry
Southold Town Clerk
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JTOWN (SEAL)
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OFFICE OF THE TOWN CLERK—
Town
LERK"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
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
Operation Permit No.�A
Fee $ / 0 -
OWNER NAME:
APPLICATION
eor
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
OWNER MAILING ADDRESS: /4 fj
.I,1 1P.I E2 DA PE, TVADDRESS: /— -5'
-
OWNER TELEPHONE NUMBER: ezgg
Application No.��
Residential
Non -Residential
DATE 719-0 • lb / (19'—/
d
TAX MAP NO.: Section 1 6 Block %/ LotS
CROSS STREET: 9-Q-- 6,c--_
TYPE OF SYSTEM: Septic Tank f New Existing
Cesspool )C New C Existing
Residential 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.)
Signature of Applicant
RECEIVED BY: Q,,��
RECEIVED ro,wn g6rk's CVffice
Tow,,. aerh Southold