HomeMy WebLinkAboutSnyder OFFICE OF THE TOWN CLERK 0 S�FFO[K�O�i
Town of Southold OHO �is -
Judith T. Terry, Town Clerk -". 4
Town Hall, 53095 Main Road , Y"
P. 0. Box 1179 F� �g�`
Southold, New York 11971x.IV
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Telephone i l
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
•
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
•
Operation Permit No. 104 Residential XX
Fee $ 10.00 Non-Residential
Septic Cesspool XX
•
NAME OF OWNER: William T. Snyder Sr.
OWNER MAILING ADDRESS: Box 1064
• Mattituck, New York 11952
OWNER PROPERTY ADDRESS: 4455 Westphalia Road
Mattituck, New York
OWNER TELEPHONE NUMBER: 516-298-4968
TAX MAP NO.: Section 113 Block 13 Lot 17
CROSS STREET: Meday Avenue
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool XX • New Existing XX
Residential XX Non-Residential
DATE OF PREVIOUS PUMP-OUT: Unknown
Judith T. Terr
Southold Town Clerk
DATE: October 21 . 1986
(TOWN, SEAL) •1_
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OFFICE OF THE TOWN CLERK c0Fu(ir -
Town of So tholc�l �� F C€, Application No. /OLf
Judith T. Terry, 'Town Clerk
Town Hall, 53095 Main Road a : ,' Residential
P. O. Box 1179 rki � Non-Residential
Southold, New York 11971 O ' f
Telephone -
est
(516) 765-1801
TOWN OF SOUTHOLD
RECEIVED SOUTHOLD WASTEWATER DISPOSAL DISTRICT
SEP 25 1980 APPLICATION
Town Clerk Southold
for
RECEIVED
.00T 21 1995 OPERATION PERMIT
Inv-1 Mrk Southold SEPTIC TANK or CESSPOOL
Operation Permit No. /O4
Fee $
?-OWNDATE C?--
OWNER
ER NAME: I at VNA t . 7 ce-
OWNER MAILING ADDRESS: O /DCo
s � X 9
OWNER PROPERTY ADDRESS: $S Lt) r
OWNER TELEPHONE NUMBER: DI " qe
TAX MAP NO. : Section //3 Block /3 Lot /7
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.)
Signatur-, of Applicant
RECEIVED BY: � ; a (--)„ K,{ )
' Town ,Verk's Office
DATE: a ,i_i , a21 , /1
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