HomeMy WebLinkAboutO'Neill OFFICE OF THE TOWN CLERK ' F� COG�'
Town of Southold � 4
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Town
Judith T. Terry, Town Clerk , /
Town Hall 53095 Main Road Ems_ " `
P. O. Box 1179
Southold, New York 11971 C-•
Telephone "'�( .a0 •
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 500 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool x
NAME OF OWNER: Eric and Gail O'Neil
OWNER MAILING ADDRESS: 840 Legion Avenue
Mattituck, New York 11952
OWNER PROPERTY ADDRESS: 840 Legion Avenue
Mattituck, New York 11952
OWNER TELEPHONE NUMBER: 516-298-8295
TAX MAP NO. : Section 142 - Block 2 Lot 14
CROSS STREET: Pacific
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing x
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: November 1586
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Judith T7Terry
ry
Southold Town Clerk
DATE: November 25, 1987
(TOWN SEAL)
OFFICE OF THE TOWN CLERK S\FF�(/��'=
Town of Southold ��� .. _ CQ� Application No.
Judith T. Terry, Town Clerk AA _4s�
Town Hall, 53095 Main Road 8 : Residential
P. -O. Box 1179 cni ; Non-Residential
Southold, New York 11971 • ���•�
Telephone : 1
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ 13
DATE 1/1-6-0. 021 1 ?177
OWNER NAME: I" GQ t ` IN 1 1--
OWNER MAILING ADDRESS: T Q L i; G ( o CJ
(vi i C 1c (Ls--( 1 I 1 2
OWNER PROPERTY ADDRESS: g�(\ LEG( 6.3
OWNER TELEPHONE NUMBER: 1(P cQ9 - 8a9 '
TAX MAP NO. : Section ) a Block a, Lot IL"(
CROSS STREET: PO- C
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool - New Existing
Residential -- NonFResi_dential_ - -
DATE OF PREVIOUS PUMP-OUT: lV0 (\ l ��
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.)
e ( QY7( I(Signature opplicant
RECEIVED ��
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DATE: Nov 251997
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