HomeMy WebLinkAboutSullivan (2) OFFICE OF THE .TOWN CLERK • 'c.OFD(�'�,®
Town of Southold - ®�t�., * ;
Judith T. Terry, Town Clerk � slur<� a°.
Town Hall, 53095 Main Road Ya u r ...
P. O. Box 1179 tI� s k ;
Southold, New York 11971 .,,,,,,,4-70 '
Telephone • I
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 384 Residential X
Fee $ 10.00 Non-Residential
Septic Cesspool x
NAME OF OWNER: George R. Sullivan-
OWNER MAILING ADDRESS: P.O. Box 837
Southold, New York 11971
OWNER PROPERTY ADDRESS: Main Bayview Road
Southold, New York
OWNER TELEPHONE NUMBER: 516-765-1376
TAX MAP NO. : Section 88 Block 2 Lot 13
CROSS STREET: Midland Parkway
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing x
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: February 1987
Judith T. Te'y
Southold Town Clerk
DATE: August 4, 1987 -
(TOWN SEAL)
`OFF`ICE OF THE TOWN CLERK ocOFO(A••"-- _
Town of Southold �� _• .• •• CQ Application No..3,`f
Judith T. Terry, Town Clerk ' f, `) Residential
Town Hall, 53095 Main Road `x, Y P. O. Box 1179 v' - ` •`' Non-Residential
Southold, New York 11971
'''2'
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Telephone .� ,,
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
•
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3t7
Fee $16
DATE 02)L / a I, / 987
OWNER NAME: 66-0,e66 P. 6ULL /C.)/9/Li
OWNER MAILING ADDRESS: Po . 10X g-.7
5OOT/JOI.a "Ay. ; 197/
1
OWNER PROPERTY ADDRESS: "9-/d BAY�/E� .P0Aa
i/hi OjJ N. Y f 1q7/
OWNER TELEPHONE NUMBER: 7(4SS- /3 76
TAX MAP NO. : Section ffg Block 4- Lot J3
CROSS STREET: /bL,9 Jp Pi9;e/(LziA y
TYPE OF SYSTEM: Septic Tank New Existing /
- Cesspool New Existing ,/
Residential .! Non-Residential
DATE OF PREVIOUS PUMP-OUT: re8 1987
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.)
Si ature o Applicant
RECEIVED BY: 4w
RECEIVEDTown C rk's Offic
DATE: NIG ()It NFU
Town Cterk Southold
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