HomeMy WebLinkAboutOchenreier JUDITH T. TERRY t r Town Hall, 53095 Main Road
TOWN CLERK
e P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS ® `1 Southold, New York 11971
�' Fax (516) 765-1823
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 1680-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner OCHSENREITER, ROBERT J.
Mailing Address 1 P. O. BOX 1194
Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
Property Address 1 600 BAYER ROAD
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-9690
Tax Map No. section 139.00 block 3 lot 18.001
Cross Street GRAND AVENUE
Date Of Last Pump Out 0/00/00
Issue Date: 5/07/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE'4JF •THE TOWN CLERK cwFFD(,(� ,t
Town of Southold Q CQ = Application No./ YU
Judith T. Terry, Town Clerk 4‘174, � $10.00 - Residential
Town Hall, 53095 Main Road 4
p. 0. Box 1179 cn „t. " 1� a
�. ,� � $25.00 - Non-Residential-
Southold, New York 11971
Telephone
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(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE 4/ ' h
OWNER NAME: 8(azpir- attSfiazii'iTafL '
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OWNER MAILING ADDRESS: 'PO 60x ti #
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OWNER- PROPERTY'ADDRESS: bOO Gi *-(,,(',v4
• OWNER TELEPHONE NUMBER: c -t 'W O
TAX MAP NO. : Section "1 ? -I Block 3 Lot )e,
CROSS STREET: Go) �
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool 1 New Existing )
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: 711'0
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.)
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Sig ture of Applicant
RECEIVED BY:
Town Clerk's Office
DATE: -
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