HomeMy WebLinkAboutTaplin OFFICE OF THE TOWN CLERK
Town of Southold �� OG
Judith T. Terry, Town Clerk � Z U, _.. =
Town Hall, 53095 Main Road ~ t=4,47. X
P. O. Box 1179 `= _
Southold, New York 11971 Q ••
Telephone _ 1 Nye
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT ,
OPERATION PERMIT
SEPTIC TANK or CESSPOOL •
Operation Permit No. 193 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool X
NAME OF OWNER: Alfreda Taplin
OWNER MAILING ADDRESS: P.O. Box 306
Southold. New York 11971
OWNER PROPERTY ADDRESS: 115 Gagen's Landing
Southold. New York
OWNER TELEPHONE NUMBER: 516-765-2935
TAX MAP NO. : Section 70 Block 1 n Lot 35
CROSS STREET: Clearview Avenue
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing x
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: October 3, 1983
•
Judith T. Terr
Southold Town Clerk
DATE: January 5, 1987
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(TOWN SEAL)
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OFFICE OF THE TOWN CLERK COMA',„•
Town of Southold �� L�G', Application No. /9?
Judith T. Terry' �
Town Clerk �� 4 t
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Town Hall, 53095 Main Road Residential
_
P. O. Box 1179 cn - rr; .` Non-Residential
Southold, New York 11971 O,ye
Telephone1 ��
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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. /��3
Fee $
• DATE //77
OWNER NAME: Alfreda Taplin
OWNER MAILING ADDRESS: p_p_ Box anti
Southold, NY 11971
OWNER PROPERTY ADDRESS: 115 Gagen' s, Landing
Southo] d, KY 11971
OWNER TELEPHONE NUMBER: (516) 765-2935
TAX MAP NO. : Section 70 Block 10 Lot 35
CROSS STREET: Clearview Avenue
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: October 30 , 1986 - IC/0 , J Vit:-3
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 licant
RECEIVED BY: evLeic, 6 �
®wn erk's O fice
DATE: 441 SAN_ ,�,�
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Town Clerk Southold
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