HomeMy WebLinkAboutReeve (4)i
Town Hall, 53095 Main Road
® P.O. Box 1179
® �® Southold, New York 11971
JUDITH T. TERRY FAX (516) 765-1823
TOWN CLERK TELEPHONE (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 1037-R Residential X Non -Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner REEVE, THOMAS / REEVE, HELEN
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Mailing Address 1 BOX 47
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Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
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Property Address 1 245 MAIDEN 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. 516-298-8404
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Tax Map No. section 140.00 block 1 lot 8.000
Cross Street COUNTY ROUTE 48
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Date Of Last Pump Out 0/00/00
Issue Date: 3/03/89
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Judith T. Terry
Southold Town Clerk
( TOWN SEAL)
OFFICE 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
APPLICATION
F F B U 009
Town W v OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. /,_-' j
Fee $ / Q
OWNER NAME: j
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS: /d/)
Application No. /� � 7
Residential t-,�
Non -Residential
DATE � k
OWNER TELEPHONE NUMBER:
TAX MAP NO.: Section /J-/6 Block i Lot g'
CROSS STREET:g
TYPE OF SYSTEM: Septic Tank New Existing /
Cesspool j/ New Existing C�
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 oficant
RECEIVED BY:
Town Clerk's Office
DATE:
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