HomeMy WebLinkAboutMeehan (2) JUDITH T. TERRY .; Town Hall, 53095 Main Road
TOWN CLERK ® '.' ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �'�se° Southold, New York 11971
��? Fax (516) 765-1823
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER ,00 Telephone (516) 765-1801
FREEDOM OF INFORMATION OFFICER �"
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3233-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner MEEHAN, ELEANOR V.
Mailing Address 1 P. O. BOX 1025
Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
Property Address 1 2015 MARLENE LANE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-9433
Tax Map No. section 144.00 block 3 lot 11 .000
Cross Street RT. 25/PECONIC BAY BLVD.
Issue Date: 8/05/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK 951F0(e�'-
Town of Southold �� CQ �; Application Not:M3
Judith T. Terry, Town Clerk y
Town Hall, 53095 Main Road = $10.00 - Residential
P. 0. Box 1179 cnwr� i �`'
$25.00 - Non-Residential
Southold, New York 11971
Telephone
(516) 765-1801-
TOWN OF SOUTHOLD
9:Cf`'C iN4SOUTHOLD WASTEWATER DISPOSAL DISTRICT •
440 de* APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation, Permit No.
Fee $ •
DATE G �� /94•
OWNER NAME:
OWNER MAILING ADDRESS: '/jo? /D 7Z
OWNER PROPERTY ADDRESS: 2o/.5 -
OWNER TELEPHONE NUMBER:
TAX MAP NO. : Section /17(-4/40 Block .9 Lot //.
CROSS STREET: ZS
TYPE OF SYSTEM: Septic Tank New Existing
'Cesspool -.)� New Existing .
Residential X Non-Residential
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:
Town .CI rk's Olffice
DATE: 45) ° 5 '1 V
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SURVEYED P Q rz ;AUTHORIZED ALTERATION OR ADDITION
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7.... ,ECTION 7209 OF TETE NEW YORK STATE
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