Loading...
HomeMy WebLinkAboutOlson ^'' % Town Hall, 53095 Main Road P.O. Box 1179 ----_"42/ %)W. ��� Southold, New York 11971 JUDITH T.TERRY TELEPHONE TOWN CLERK (516) 765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 700-R Residential X Non-Residential Fee $ 10. 00 Septic Cesspool X New X Existing Name Of Owner OLSON, JOHN A. Mailing Address 1 33 GREENHILLS ROAD Mailing Address 2 City St Zip HUNTINGTON STATION NY 11746-0000 Property Address 1 785 SUTTON PLACE Property Address 2 City St Zip GREENPORT NY 11944-0000 Owner Telephone No. 516-673-5481 Tax Map No. section 33 . 00 block 5 lot 4. 000 Cross Street MC CANN LANE Date Of Last Pump Out 0/00/00 Issue Date: 5/13/88 Judith T. Terry Southold Town Clerk (TOWN SEAL) OFFICE OF THE TOWN CLERK %IFV•�'� 11 Town of Southold �� CQ Application_ No./Qv Judith T. Terry, Town Clerk 4 iA Town Hall 53095 Main Road ` Residential (TIN,t ,r- �, P. O. Box 1179 ' � � 'N � ��a . Non-Residential Southold, New York 11971 O ® •� Telephone -.7614"' (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for - - OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 70 Fee $ /O oP DATE - -/*/7*** OWNER NAME: ONl{/ 4". ©25'x✓ OWNER MAILING ADDRESS: 3 GSA /4AS � Ivdt,77434.7o.k.) X57 . ,.�- //7Y- OWNER PROPERTY ADDRESS: 785' 3`1". 00 OWNER TELEPHONE NUMBER: (3i7 ) 73-- TAX MAP NO. : Section 3'3 Block Lot y CROSS STREET: 3bbO / /lc �1q�� �� • TYPE OF SYSTEM: Septic Tank 17/ New Existing Cesspool ✓ New Existing Residential B/ Non-Residential DATE OF PREVIOUS PUMP-OUT: `►/, Ltd 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.) • Signature of Applicant RECEIVED own / lerk s o fice DATE: MAY 131988 Town Crept Southote . t-40. 1, :, L. t} fi - /f�N`Gam. (�`i i 11 ,_ E. '11'5. r ` / .6:"VaArE. ;411\1 1--t---,...-..--. - - \r 50 SLIT-TON PLACE '-`-_ ! 220 Q ""--320 TO MCCANN �tik1EN.14 (;4 fO E, foo.0 .- • c 0 , __ in c- ss 4 376 m . o i , ' 10 _rcc 1 _.J 1 1) ( A r1-0(411�;Tr T/'CI 1 . .J d.'J� t� ) 1 1� i i i.i; tx) I D ( ) o t -; t.11 -_. ______(65.83) _ 'f ti.) > _��,.740 t.37.3`.x, ":;,;-11h. r• C. r 1 i 1 t LOT'..1 A Q'5. Ei r TO MAP OF U A 1 i:f.l!'.S : - CL) it-,i i c--tE G',7,1..:1-.1",�o� .�.u-r2K's_C_rP i .F_ A`7, 11A,P_HO. 't.1r� ! . .2.ToPoGc ApH%,t( ) `t GE€31.::Q,AL.t._.Sy' s 1. -i` t 1=:�:.,=`_ ' 'i:: ':..:•,N,„,,..''A�,`_ 1.1.:LO E:: , 4.ETA,Nt -EA.I_ . .0 F ? �•,, {tom, i'�•,. _... ......'' TELEDYNE POST ' N61329