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HomeMy WebLinkAboutSmith (6) • OFFICE OF THE TOWN CLERKFa Town of Southold 0 � �.4 Judith T. Terry, Town Clerk � ." :f�' 0 Town Hall, 53095 Main Road o ; ' P. O. Box 1179Os' F41 Southold, New York 11971 Q " " o' Telephone fid (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation- Permit No. 543 Residential X Non-Residential Fee $ 10.00 Septic Cesspool X NAME OF OWNER: Russell J. Smith OWNER MAILING ADDRESS: 45 Sunset Lane Greenport, New York 11944 OWNER PROPERTY ADDRESS: 45 Sunset Lane Greenport, New York OWNER TELEPHONE NUMBER: 516-477-1061 TAX MAP NO. : Section 33 Block 4 Lot 54 CROSS STREET: Sound Drive TYPE OF SYSTEM: Septic Tank New Existing Cesspool X New Existing x Residential X Non-Residential DATE OF PREVIOUS PUMP-OUT: November 29. 1985 • ...04.4.•..-4. gogle Judith TMo`� , Southold Town Clerk DATE: December 17. 1987 (TOWN SEAL) - 1 ..- - I OFFICE OF THE TOWN CLERK cOFD(/r.'- ,, // Town of Southold % = e& Application No.VS`7`3 c .Judith T. Terry, Town Clerk % At R"0 X1''1 Town Hall 53095 Main Road 1 i�'",_< mC Residential P/ P. 0. Box 1179 cr' Non-Residential Southold, New York 11971 O 1;. -, �.s Telephone 0 0► �� (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ 1 0, 0 O - DATE /,t®, / 7— 1g97 OWNER NAME: S`c.) ,g' J L j, 051y) ; 7"1-d OWNER MAILING ADDRESS: ,46--- f)oti5E7 LA ,-1L P- fO27-_. il•y OWNER PROPERTY ADDRESS:- I55O CY ---)e T 1. A rii G rip tbrT N,/ if 546,1 OWNER TELEPHONE NUMBER: L ') .497 — / © 6 / TAX MAP NO. : Section 3 ' — Block - Lot CROSS STREET: s`r)GUNI 4 .ri J - TYPE OF SYSTEM: Septic Tank New Existing Cesspool ✓ New Existing Residential ✓ Non-Residential DATE OF PREVIOUS PUMP-OV: 1.b(/..- c;T 9 _ / q W''' 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.) .�. 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