HomeMy WebLinkAboutMurphy (6) _ � 9
OFFICE OF THE TOWN CLERK s 'c0FeUre
Town of Southold ,� 0� ,
Judith T. Terry, Town Clerk », Ar*
Town Hall, 53095 Main Road
P. 0. Box 1179 Yet
Southold, New York, 11971 0 fib:1�` 0��1
Telephone : 1
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 93 Residential XX
Fee $ 10.00 Non-Residential
Septic Cesspool xx
•
NAME OF OWNER: Thomas W. Murphy
OWNER MAILING ADDRESS: 678 President Street
Brooklyn, New York 11215
OWNER PROPERTY ADDRESS: 1295 Sigsbee Road
Mattituck, New York
OWNER TELEPHONE NUMBER: 1-718-789-7472
TAX MAP NO. : Section 144 Block 2 Lot 6
CROSS STREET: Main Road and Peconic Bay Blvd. -
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool XX New Existing xx
Residential XX Non-Residential
DATE OF PREVIOUS PUMP-OUT: July 7, 1986
depuftwifoovio
Judith T. Terr
Southold Town C erk
DATE: October 16, 1986
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(TOWN SEAL) • .
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OFFICE OF THE TOWN CLERK �C•3\\FH((
Town of Southold CQG Application No. O'.3
Judith T. Terry, Town Clerk 40.;.
_
Town Hall, 53095 Main Road .t. Residential
P. O. Box 1179 c p ' ' z Non-Residential
Southold, New York 11971 O�f"'t `0 •
to
Telephone
(516) 765-1801
R CE VED TOWN OF SOUTHOLD
OCT 06 M6 SOUTHOLD WASTEWATER DISPOSAL DISTRICT
Town Clerk Southold
APPLICATION
R CE V'D
o' iBB i for
I J
�,;k STOW
OPERATION PERMIT
rc" ' C:,
SEPTIC TANK or CESSPOOL `
Operation Permit No. 93
Fee $ /O °`
DATE s27 '' 2' /y
OWNER NAME: / 4"1# dvieP/4'
OWNER MAILING ADDRESS: '7J" /5 - 1 dw''&174--
16/e/yA/ ,/-y . / ( L- /
OWNER PROPERTY ADDRESS: 42 93" 3'7���
�/y _ /19s).
OWNER TELEPHONE NUMBER: 1- 71$- 7P7 7a2(3k/p/)
TAX MAP NO. : Section / Block Lot co
CROSS STREET: 41) f✓ / oA ci v ` ���`" c /2A- et,
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool !/ New Existing
Residential ✓ Non-Residential
DATE OF PREVIOUS PUMP-OUT: 1 .i
i 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.)
�+yu Lam/ :keg.
Signature of Applic.'nt
RECEIVED BY: 6 - c �,r � r J
Town 'erk's Office
DATE: aJx ) /6, 7S/'
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L - . . AT ' ' • • stiff Co. Clerk's Office as mop no. 801
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' • - • • and Mortgage Co. os surveyed octabl°r 16,1971
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