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HomeMy WebLinkAboutReiter (3) ,o Ii, .. 1 / JUDITH T. TERRY ac Town Hall, 53095 Main Road TOWN CLERK rrri P.O. Box 1 179 REGISTRAR OF VITAL STATISTICS ih Southold, New York 11971 MARRIAGE OFFICER 10° Nr •� Fax (516) 765-1823 • 14. 1� Telephone (516) 765-1801 1 11 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 3003-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New Existing X Name Of Owner REITER, JOSEPH AND BARBARA Mailing Address 1 55 BIRCH LANE Mailing Address 2 City St Zip CUTCHOGUE NY 11935-0000 Property Address 1 55 VIRCH LANE Property Address 2 City St Zip CUTCHOGUE NY 11935-0000 Owner Telephone No. 516-734-5658 Tax Map No. section 83.00 block 1 lot 31 .000 Cross Street DUCK POND ROAD Date Of Last Pump Out 0/00/00 Issue Date: 4/19/93 Judith T. Terry Southold Town Clerk (TOWN SEAL) OFFICE OF THE TOWN CLERK •0�FFO � ( Town of Southold �5 - " CQ Application No. 0 Judith T. Terry, Town Clerk ry Town Hall, 53095 Main Road - 0 4 : $10.00 - Residential p. O. Box 1179 tri i" re71 � $25.00 - Non-Residential Southold, New York 11971 O s Telephone,( `ge� '� (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ DATE App-k ) 3 )619.3 OWNER NAME: jo s er In I • ar► d 6a r 6q,ra D , Re OWNER MAILING ADDRESS: 5 5 , r0 C, u-1-GA, 03 ue j New `{ork \\a 35 OWNER PROPERTY ADDRESS: 5 5 e y Cr In La lies/ C� v►-��_ Ddb Lt f New 1 O cA< i1G135 OWNER TELEPHONE NUMBER: 5 l - 13 61 _ 56 5 7 TAX MAP NO. : Section Block l Lot CROSS STREET: 0 0,(`Y. 'l'o►�lc� k� )ci TYPE-'OF -SYSTEM: Septic Tank New Existing Cesspool New Existing I/ Residential (7 Non-Residential / DATE OF PREVIOUS PUMP-OUT:V2-,r-V VUrnQ-c� 33)15 [ g3 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.) Ler *-CD Sign ur- of Applicant 6 -RECEIVED-BY!' Town Clerk's Office DATE: - _ . _ ; ; Cu-Ict+o G_ -U 1 - , '- ' '4 (Z:Z: p A k r. - , - ♦ ' • V - ff -� , r , 1 5��., . r ly\,.: `'+' r sy '� , .f• T ._ sA e f ,_ . - - . . , p . , ,rr ` - _' - - - ' - _ :,' i, ,,,,s r _ - - ^� ; - -s -i-- LE ;� ,� .r i - - - - _ _ _ .-. '�.; �:' _ _ + 1f "VV , - .,- -- r _ . .. ., _ i- CCC_/// ., ` - . - - 'r' ..= , , . . . _ ., , ,. ._ . _ . . . .. . „ . „, r., . , .... . _ ." .. ., . _„ , . , _ . . . . , ,,,, , . . . . . . , .... . , . . , , . . , 0 . , . , .. . . .._ .. _ ____ . ...__ . . ... ... _,_ , ... ., . , # _ . .. ,.._. , . . . - .. , -13rba -= " D .' Ie � �� • .Cu4ch .ogQ.e- _- -,