HomeMy WebLinkAboutMellas 'coliti
I .7 f.
$41`
1�O.
Ill
1 b
Town Hall, 53095 Main Road
�+® ' O��`� P.O. Box 1179
1 �o° Southold, New York 11971
JUDITH T.TERRY ._- #yid,, ,l TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE,OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 730-R Residential X Non-Residential
Fee $ 10. 00 Septic Cesspool X
New Existing X
Name Of Owner fELLAS, HAROLD D.
Mailing Address 1 P.O. .BOX 44
Mailing Address 2
City St Zip SOUTHOLD NY 11971-0000
Property Address 1 CLEARVIEW AVENUE
Property Address 2
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 516-765-2578
Tax Map No. section 70. 00 block 8 lot 43 .000
Cross Street WILLOW POND ROAD
Date Of Last Pump Out 0/00/00
Issue Date: 6/10/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
a ��
OFFICE OF THE TOWN CLERK cOFO(r
Town of Southold ..- CQG';, Application No.7c3
Judith T. Terry, Town Clerk �� , t '\
� , Residential
Town Hall, 53095 Main RoadY P. O. Box 1179 cnv ` ` Non-Residential
Southold, New York 11971 O �� X-r
Telephone .( 1 '°
.(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ /'O
DATE 00e5
OWNER NAME: ,-6&b ‘/�,
OWNER MAILING ADDRESS: ,���y (2Lzwtg'eee)'
ei}a€,)
G/)/ /0-ik 1/97/
OWNER PROPERTY ADDRESS: ,&31911-1Z0
.�, r'a 12-5! 1/97/
OWNER TELEPHONE NUMBER: 7I,"-zc7('
TAX MAP NO. : Section %6 Block 5 Lot 4/5
' CROSS STREET: Ze-4.-/-24-40.) /0a7cd_ fed
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential /� Non-Residential
DATE OF PREVIOUS PUMP-OUT: 7/,1
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.)
A /e/(41
ignature of, Applicant
RECEIVED BY:
E ► Town Ierrk'
Mffe
DATE: MIN 1 01988
Town Clerk Srn tho
la
— — - -- _
I � i6=',-/hevc-7z")if6
1 l1A
j
atI id ' ' ‘.
s\'4 I „..„...Tep 0
, - - 1
-1.
r----" ,
.. ,,,
♦2 - , ail
1
t
,