HomeMy WebLinkAboutReevesJUDITH 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. 3549-R Residential X Non -Residential
Fee $ 10.00 New Existing X
Name Of Owner REEVES, JOHN C.
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Mailing Address 1 115 WASHINGTON AVENUE
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Mailing Address 2
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City St Zip GREENPORT NY 11944-0000
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Property Address 1 115 WASHINGTON AVENUE
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Property Address 2
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City St Zip GREENPORT NY 11944-0000
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Owner Telephone No. 516-477-1290
Tax Map No. section 41.00 block 2 lot 10.000
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Cross Street MI DDLETON ROAD
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Issue Date: 11/18/96 Judith T. Terry
-------- Southold Town Clerk
(TOWN SEAL)
s
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
Application No.,S
$10.00 - Residential
$25.00 - Non -Residential
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
OWNER NAME:
OWNER MAILING ADDRESS:
DATE
ry d. S h L" 4
OVINER PROPERTY ADDRESS:- '5"_4 199
I
OWNER TELEPHONE NUMBER: 7 / �-
TAX MAP NO.: Section Block Lot / CJ
CROSS STREET:
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool .-N ew 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.)
RECEIVED BY:
Town Cleric's Office
DATE:
1�
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