HomeMy WebLinkAboutMurphy (5) SI ��fo
$ Town Hall, 53095 Main Road
// P.O. Box 1179
®1 � �! Southold, New York 11971
JUDITH T.TERRY �. „,,,,,"� TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWNCLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 801-R Residential X Non-Residential
Fee $ 10. 00 Septic Cesspool X
New Existing X
Name Of Owner MURPHY, PAUL AND RITA
Mailing Address 1 BOX 735
Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
Property Address 1 WEST VIEW DRIVE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-4967
Tax Map No. section 139. 00 block 1 lot 5.000
Cross Street BROWER ROAD
Date Of Last Pump Out 0/00/00
Issue Date: 8/26/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
6
OFFICE OF THE TOWN CLERK C31HU( = p
Town of Southold -%rte CSG; Application No. c Q/
Judith T. Terry, Town Clerk . RI
Town Hall, 53095 Main Road' '_."FZ,A. : Residential
' `ice. +•7x tr3`
P. O. Box 1179 r �''' ;� +moi Non-Residential
Southold, New York 11971 O '1%ii.'fr..0 *-6$
Telephone SQ( , i�
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ /D. •°'''
P
. DATEA, r 1y
OWNER NAME: 4--11', /
C�-ue
OWNER MAILING ADDRESS: /; 7.3.
C �. 1 / 9
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OWNER PROPERTY ADDRESS: 1;P�, �,cett) 7
11,
OWNER TELEPHONE NUMBER: ��r- ?‘-/ /
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/5-7-0
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TAX MAP NO. : Section / 9- Block Lot _
0°kAiMCROSS STREET: ,..1 GAJ 7ecf- --e
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool 6l New k,-;` Existing v----
Residential � Non-Residential
DATE OF PREVIOUS PUMP-OUT: 4/917
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.)
Sig ..ture o . .lint
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RECEIVED BY: G L-te„- 0
RE ro ® Town clerk's ' ffice 0
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DATE: C`,
, -.-' Srs-,"" [71 (-) ((
Towe Clerk Southold <-----
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