HomeMy WebLinkAboutOur Lady of Ostrabrama Church `,, dvcv
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V? Town Hall, 53095 Main Road
4.
P.O. Box 1179
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JUDITH T.TERRY /�r!�� FAX(516)765-1823
TOWN CLERK TELEPHONE(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. 1288-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner OUR LADY OF OSTRABRAMA
Mailing Address 1 CHURCH RECTORY
Mailing Address 2 BOX 997
City St Zip CUTCHOGUE NY 11935-0000
Property Address 1 DEPOT LANE
Property Address 2
City St Zip CUTCHOGUE NY 11935-0000
Owner Telephone No. 516-734-6446
Tax Map No. section 96.00 block 5 lot 12.002
Cross Street ROUTE 25 AND NORTH ROAD
Date Of Last Pump Out 0/00/84
Issue Date: 10/30/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
III •
OFFICE OF THE TOWN CLERK 'COMA,
Town of Southold �� CQ Application No./
Judith T. Terry, Town Clerkt' i :�
r s _; .G $10.00 - Residential
Town Hall, 53095 Main Road � r
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P. O. Box 1179 cn Vis;•:-.• mr` h�i �` $25.00 - Non-Residential
Southold, New York 11971 O
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ $10 . 00
DATE Oct 17 , 1989
OWNER NAME: Rectory of Our Lady of Ostrabrama Church
OWNER MAILING ADDRESS: Box 997- 1300 Depot Lane, Cutchogue
OWNER PROPERTY ADDRESS:
OWNER TELEPHONE NUMBER: 734-6446
o✓ 6 -s- JO,TAX MAP NO. : Section - Block 6 Lot --4+
CROSS STREET: Rt 25 & North Road
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: October. 13, 1984
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.)
Z• nature of A li - nt
RECEIVED BY:
Town Clerk's Office
DATE:
OCT 3 01989
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3300 Depot Lane �, Cutchogue
50 '
3 car garage
ci? #1
10 '�
Rear Door
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rt•
o House
01
Front Door
DEPOT LANE