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HomeMy WebLinkAboutOverton , ,_ Y y Town Hall, 53095 Main Road �® 1 P.O. Box 1179 4)1$ Southold, New York 11971 JUDITH T.TERRY ,---,-, ,, o• 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. 706-R Residential X Non-Residential Fee $ 10. 00 Septic Cesspool X New Existing X Name Of Owner OVERTON, EDITH Mailing Address 1 SOUTH HARBOR ROAD - Mailing Address 2 City St Zip SOUTHOLD NY 11971-0000 Property Address 1 SOUTH HARBOR ROAD Property Address 2 City St Zip SOUTHOLD NY 11971-0000 Owner Telephone No. 000-000-0000 Tax Map No. section 78. 00 block 3 lot 1.000 Cross Street BAYWATER AVENUE Date Of Last Pump Out 0/00/00 Issue Date: 5/17/88 Judith T. Terry Southold Town Clerk (TOWN SEAL) ry OFFICE`OF THE TOWN CLERK �COFD(ir��= Town of Southold Appli- cation No. 7O ' Judith T. Terry, ,Town Clerk +4` Town Hall, 53095 'Main Road `;t? ' "� ) Residential £� P. O. Box 1179 ��� re; Non-Residential Southold,. New York 11971 O ®.'-. Telephone (11 411 ‘1 ;q ‘1 (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT MAY 131999 APPLICATION Tam Ctorti, So!, - for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 7Ob Fee $ /4)4'' DATE /1t� /d ?d • OWNER NAME: OI 1 l (Jj7O Iv OWNER MAILING ADDRESS: So i R ©R- (P 5od� (�o �OW. ' , / 77/ OWNER PROPERTY ADDRESS: OWNER TELEPHONE NUMBER: TAX MAP NO. : Section 7 g Block 3 Lot CROSS STREET: BA y Vlf Pr7— TZ A u r~ TYPE OF SYSTEM: Septic Tank t/ New Existing Cesspool ✓ New Existing z/ Residential 1/ Non-Residential DATE OF PREVIOUS PUMP-OUT: / P f� ( 1 9 ~ /96 '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.) Signature of Applicant RECEIVED BY: � TownC rk's 0 fice • DATE: MAY 1-71996 Town Mott Sow ,Id - r } Y - D R 1 ✓�'JwP`/ cJ) 9 f 0 • CES5Pb°L' G- - TRAP -TRAP