HomeMy WebLinkAboutMurray (2) oFFOLt
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JUDITH T.TERRY • ® y.i 7 s Town Hall, 53095 Main Road
TOWN CLERKco5S t P.O.Box 1179
x�`` � Southold,New York 11971
REGISTRAR OF VITAL STATISTICS ;, O1 Fax(516)765-1823
MARRIAGE OFFICER '4 ?-
RECORDS MANAGEMENT OFFICER =:®��d ,w ��/��� Telephone(516)765-1800
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. 3380-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner MURRAY, DANIEL AND JACKIE
Mailing Address 1 21 PROSPECT PLACE
Mailing Address 2
City St Zip RIVERHEAD NY 11901-0000
Property Address 1 60 KING STREET
Property Address 2
City St Zip NEW SUFFOLK NY 11956-0000
Owner Telephone No. 516-727-8231
Tax Map No. section 117.00 block 8 lot 1 .000
Cross Street FIFTH STREET
Issue Date: 9/12/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
-=QF OF THE TOWN CLERK c3�FFO(, �"
�
�urn of Southold lQGt,, Application No.33_2_0
- • . Terry, Town Clerk
Town Hall, 53095 Main Road $10.00 - Residential -----
P. 0. Box 1179 cn `' $25.00 - Non-Residential
Southold, New York 11971 ��`
Telephone 70 Jig ��� �
(516) 765-1801 -
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE c ' 07
OWNER NAME: ,�,1/lJ/; � ce c/j�� ,4(, `'
OWNER MAILING ADDRESS: Z/ , 'i2 67:W-c r
1—.(t2,p , )M //99/
OWNER PROPERTY ADDRESS : - 1, 0 - le/4J
xJ,Qu &/r A9,7
OWNER TELEPHONE NUMBER: 0/(o i-rZ7 8 Z 3J
m
TAX MAP NO. : Section (/ /7 Block d Lot
CROSS STREET: f//`::-7,
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New c Existing
Residential 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.)
40 46.,.
'W ature of Applicant
RECEIVED BY: (A)/C'e/v"
Townl Clerk's Office
DATE: K )1' I��s
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