HomeMy WebLinkAboutSonnenborn AV Wire;
_ . na Town Hall, 53095 Main Road
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� �� P.O. Box 1179
® �r Southold, New York 11971
JUDITH T.TERRY / ,c?PFAX(516)765-1823
TELEPHONE(516)765-1801
TOWN CLERK
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 1331-R Residential X Non-'Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner SONNENBORN, DONALD E.
Mailing Address 1 132 BREWSTER ROAD
Mailing Address 2
City St Zip SCARSDALE NY 10583-0000
Property Address 1 SOUNDVIEW ROAD
Property Address 2
City St Zip ORIENT NY 11957-0000
Owner Telephone No. 212-903-7860
Tax Map No. section 15.00 block 3 lot 12.000
Cross Street THREE WATERS LANE
Date Of Last Pump Out 0/00/00
Issue Date: 12/05/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
Y . II,
OFFICE OF THE TOWN CLERK "c3\\FFD(,
Town of Southold � _ C� - Application No. 333/
Judith T. Terry, Town Clerk k
Town Hall, 53095 Main Road ir 4 °:,�.5�� ..0 $10.00 - Residential
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p. O. Box 1179 C!7 wf; A 1 •_��� •
s, s,;f • $25.00 - Non-Residential
Southold, New York 11971 O "® S't7 0���`
Telephone JifiNit
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(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
- _ - - -
for _ _� v--- - -
- OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE R218'1
OWNER NAME: tphat_p E. Sp AP.; kiaa(L.1 '
OWNER MAILING ADDRESS: 130., 13R6wSTF62, 42on0
ScARs0/4 ..is , 5g3
OWNER PROPERTY ADDRESS: - -S1144.1d 11 itc..a 42,A-ad. -
ORMLIT , u ..J. 1°101
OWNER TELEPHONE NUMBER:a)� � �bz riR‘D 1, 1-4)149 2 22.15
TAX MAP NO. : Section 15 Block 3 Lot 1.2.
CROSS STREET:
TYPE OF SYSTEM: Septic Tank - New Existing
Cesspool v New Existing V'
Residential v/ Non-Residential
DATE OF PREVIOUS PUMP-OUT: tNov .a 2 Dec- oi- 14/78
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 Applicant
RECEIVED BY:
Town' Clerk's Office
DATE: -
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