HomeMy WebLinkAboutReinhardtJUDITH T. TERRY
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 2087-R
Fee $ 10.00
Name Of Owner
Mailing Address 1
Residential X
Septic
New
Non -Residential
Cesspool X
Existing X
REINHARDT, ELLA (ESTATE OF)
------------------------------
P. O. BOX 128
------------------------------
Mailing Address 2
------------------------------
City St Zip SOUTHOLD NY 11971-0000
-------------------- -- ----------
Property Address 1 2655 REYDON DRIVE
------------------------------
Property Address 2
------------------------------
City St Zip SOUTHOLD NY 11971-0000
-------------------- -- ----------
Owner Telephone No. 516-765-3900
------------
Tax Map No. section 80.00 block 3 lot 7.001
------ --- ------
Cross Street WEST SHORE DRIVE
------------------------------
Date Of Last Pump Out 0/00/00
Issue Date: 3/26/93 Judith T Terry
-------- Southold Town Clerk
(TOWN SEAL)
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
Town of Southold
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 11971
Telephone
(516) 765-1801
Application No.
$10.00 - Residential
$25.00 - Non -Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
rr�
DATE -3 - -2- 9 3
OWNER
NAME:
S T. Le- A 1-2, rIN///)R D7_ !f ^d
OWNER
MAILING
ADDRESS: 0-7
OWNER
PROPERTY ADDRESS:
OWNER
TELEPHONE NUMBER: 765
3 r70-0e-�_j 7 l0-7
TAX MAP NO.:
Section q73 F8,7 Block
3'0 , Lot —3-7.1
CROSS
STREET:
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New 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:
Town Clerk's Office
DATE:
9
I
PA'f/