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HomeMy WebLinkAboutSonner OFFICE OF THE TOWN CLERK I 4\V 1., Town of Southold Judith T. Terry, Town Clerk .1' ;',:•1+ `,-A Town Hall, 53095 Main Road P. O. Box 1179 �� tis urs : Southold, New York 11971 `�' `�•� O Telephone .( (516) 765-1801 `- TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 173 Residential X Fee $ 10.00 Non-Residential Septic Cesspool X - NAME OF OWNER: Doris Sonner OWNER MAILING ADDRESS: Bay Road, Box 506 Greenport, New York 11944 OWNER PROPERTY ADDRESS: Bay Road Greenport, New York OWNER TELEPHONE NUMBER: 516-477-1146 TAX MAP NO. : Section 43 Block 5 Lot 8 CROSS STREET: Sandy Beach Road TYPE OF SYSTEM: Septic Tank New Existing Cesspool X New Existing X Residential X Non-Residential DATE OF PREVIOUS PUMP-OUT: July 1984 ? • Judith T. Terry Southold Town Clerk DATE: December 9, 1986 I i - (T WN SEAL) ti e cF _ _ d � OFFICE OF THE TOWN CLERK �/�FFO �' Town of Southold �% CQG Application No. Judith T. Terry, Town Clerk .ti.„,,.... , i-F y 2/ Y. � ��' _ < l Residential Town Hall, 53095 Main Road 0:,_ , -� P. O. Box 1179 cn =� V Z' Non-Residential Southold, New York 11971 O�% l �`� 0�° Telephone _ .( ', (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. / 73 Fee $ /0 v DATE .1C.• 10) IV) OWNER NAME: .L aJ Oif i S • J v (NoitwAtc OWNER MAILING ADDRESS: (kb . 'BS6 1Q (NY 0 LI i‘ Tic, 4. - OWNER PROPERTY ADDRESS: .0.,11V1e OWNER TELEPHONE NUMBER: 61 (Q 14 7 7 114-6 j TAX MAP NO. : Section +3• r.5 "'4g Block Lot CROSS STREET: a TYPE OF SYSTEM: Septic Tank New Existing Cesspool f New Existing V Residential / Non-Residential DATE OF PREVIOUS PUMP-OUT: T//4 (?) 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.) , aliut, 01A oad.) x Signat re of Applicant RECEIVED BY: (// ri raq__,4, , , , movED own CI' rk's Of e DATE: I! % II !, long Iowa Clark Southold -41!' Loyal. k. • F té- s SC V_VYS_QZ( ekf- Lict9-44,