HomeMy WebLinkAboutMorcombe 43,
JUDITH T. TERRY Town Hall, 53095 Main Road
TOWN CLERK ��1 P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
O_ Fax (516) 765-1823
MARRIAGE OFFICER y /� �g •
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Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 1916-R Residential' X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner MORCOMBE, DEREK AND ESTHER
Mailing Address 1 615 ISLAND VIEW LANE
Mailing Address 2
City St Zip GREENPORT NY 11944-0000
Property Address 1 615 ISLAND VIEW LANE
Property Address 2
City St Zip GREENPORT NY 11944-0000
Owner Telephone No. 516-477-2123
Tax Map No. section 57.00 block 2 lot 25.000
Cross Street BAYSHORE ROAD
Date Of Last Pump Out 0/00/86
Issue Date: 6/02/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL) •
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FFICE OF THE TOWN CLERK � FO(,(��'• _
Town of Southold �� CQ Application No. /9/c
Judith T. Terry, Town Clerk .� '. c„, i►
Town Hall, 53095 Main Road ~ -� $10.00 - Residential
P. O. Box 1179 c.n 'R? $25.00 - Non-Residential
Southold, New York 11971 -7-
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Telephone .? 1P:
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
•
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. /9/6
Fee $ /
DATE JUNE 1 , 1992
OWNER NAME: Derek & Esther Y. Morcombe
OWNER MAILING ADDRESS: 615 Island View Lanc Rt. 1
Greenport, N.Y. 11911
- OWNER PROPERTY ADDRESS: SAME AS ABOVE
OWNER TELEPHONE NUMBER: 516 - 477 2123
TAX MAP NO. : Section 57 Block 2 Lot 25
CROSS STREET: Bayshore Road
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing X
Residential X - Non-Residential
• DATE OF PREVIOUS PUMP-OUT: January, 1906
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.)
•
`_Ppm
S' nat "e Applica
RECEIVED BY: iilf
Town Clerk's Office - - -
DATE: 677t7/7f___ - -
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1 ' - -, 1 �i- V ( & LA/AT:
615 Island View Lane Rt . 1
Greenport, N.Y. 11944
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