HomeMy WebLinkAboutStars OFFICE OF THE TOWN CLERK • cgFilLI'
Town of Southold O�O•t ��
Judith T. Terry, Town Clerk •%Zy •', -'
Town Hall, 53095 Main Road K
P. 0. Box 1179 '` r1 r:4)7 w , yc •
Southold, New York 11971 `Y Tb:-' Nr-
Telephone zeNg
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 475 Residential x
Non-Residential
Fee $ 10.00
Septic Cesspool x
NAME OF OWNER: Mr. and Mrs. William Stars
OWNER MAILING ADDRESS: P.O. Box 942
Mattituck, New York 11952
OWNER PROPERTY ADDRESS: Wickham Avenue
Mattituck, New York
OWNER TELEPHONE NUMBER: 516-298-9648
TAX MAP NO. : Section 140 Block 1 Lot 3
CROSS STREET: North Road (C. R. 48)
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing x
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: Unknown
Judith T. rry
Southold Town Clerk
DATE: October 28, 1987
(TOWN SEAL)
iii
OFF-ICE ;oF THE TOWN CLERK .cSFair
Town of Southold CQ� Application No. hJ
/7
Judith T. Terry, Town Clerk �� T;
Town Hall, 53095 Main Road ' ' . �, Residential
P. O. Box 1179 U rte`, t Non-Residential
Southold, New York 11971 ® �0 ,���
Telephone ,(
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
fo r-
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. `'7
Fee $
DATE al I 0.6T, /qc�
OWNER NAME: Ate 4"A '5 t62//_t/40 5 ire 5
OWNER MAILING ADDRESS: P() TOS)( # Aga_
/1ii-r77rAZ N V Al. /if 5;2
OWNER PROPERTY ADDRESS: t0I f (/-4,4AI AVE
r-1 C,( i(/-/ #//�9�
OWNER TELEPHONE NUMBER: Me- 9ig
TAX MAP NO. : Section /1/0 Block / Lot 3
CROSS STREET: .
TYPE OF SYSTEM: Septic Tank u New Existing
Cesspool � New Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: (ik,ev0 c
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.)
�l.. ` 4 _ _
Signatu7 of Applicant
RECEIVED BY:�' •
tb 'V erk's O fice
DATE: OCT 281987
Town Clerk Southold
. ,
. ,
, . .
• ,
. . ._._____,
. .
I- !__ _
1 , • ,
, C ,
. 1
' 111111111116114 ' ',
lb '
. ,
' • , , ' .
. ,
. .
. , .
4
. ,
, u —e .
, • . 1 -40)1.e.-- . - .
. . .
i
,
, . , _ ..... 1
. _
A i