HomeMy WebLinkAboutStepnoski (2) I
44P C3‘0 tbe,
JUDITH T. TERRY ,
''.', � ��
Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
®
REGISTRAR OF VITAL STATISTICS H a : '+ -� Southold, New York 11971
MARRIAGE OFFICER
�Y Fax (516) 765-1823
�� �' Telephone (516) 765-1801
4!--„,„„„„--
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 1775-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner STEPNOSKI, BERNARD L & BEVERLY
Mailing Address 1 P. O. BOX 336
Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
Property Address 1 505 REEVE AVENUE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-4121
Tax Map No. section 114.00 block 9 lot 8.000
Cross Street NEW SUFFOLK AVENUE
Date Of Last Pump Out 0/00/00
Issue Date: 10/04/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
i- • r
OFFICE OF THE TOWN CLERK •c�V�FO(,�'��'
Town of Southold ' - Application Application No.� 5T
y
Judith T. Terry, Town Clerk �' e ;
Town Hall, 53095 Main Road -� $10.00 - Residential
P. O. Box 1179 U-3tr'2, • _ $25.00 Non-Residential
Southold, New York 11971 O " `` *'/Telephone ( y
(516) 765-1801
TOWN OF SOUTHOLD
•
• SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE /0/tfl9/
Q
OWNER NAME: !JE/-�/Mle•U L' ,(9P(D gG UERLy SrEPA/OSk',
OWNER MAILING ADDRESS: P.O , 8c 33‘
2,9 T UG k/ y
OWNER PROPERTY ADDRESS: cos RE-EU M'e.
772A 7-7"i TZ-1G
OWNER TELEPHONE NUMBER: ( 76) 498-- 4)(2.,
TAX MAP NO. : Section i q Block O9 Lot OOg
CROSS STREET: NEW S,FpOLk /90E.
TYPE OF SYSTEM: Septic Tank - - New Existing
Cesspool V" New - Existing 1/-
Residential
-Residential 1V' Non-Residential
DATE OF PREVIOUS PUMP-OUT: 9/ /17/
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 of Applicant
RECEIVED BY: lr� r - -
REcEDnrn Clerk's Office
DATE: OCT ®4. 491 '
Town Clerk Southold
t
•
.
/
Z
/ or formerly
now a Elizo�ih F�onell
Sion'sone \\
�l
\ 1
106.2
m,
S 2`5 40'
0 Nt
c it
Jp
$a a
If-
til
SHao 1
N ° S o 1
N oo
Ky
LLin
36.€:- - - \
0 °
3 S• 222
ac
1!
Z
�
N _ ' 3Lo(• \� 1
N
G_ \ 1
\ W
cc
T G \ ►'
Q • \ K
N •o , c
zr
�f 11 .r \ .
o ,ti. ► 0
to \ ,j '0
O •NO rack 'r.\ 0 N
3J \ � � N� '� N a► 'ID i
0 N • n Nu .o, 11 ,\ N
c Z: ,•ga 0 \ Co
,..\ ?•;(32
og
} •• CO O►
9°-5 VIP
N