HomeMy WebLinkAboutTrainor OFFICE OF THE TOWN CLERK fULA:
Town of Southold c� �G
- Judith T. Terry, Town Clerk �•�Z ��, �,�;� �
Town Hall, 53095 Main Road - 1 "ac
P. O. Box 1179 n VA,
Southold, New York 11971 I p
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT.
• OPERATION PERMIT
SEPTIC TANK or CESSPOOL -
Operation' Permit No. 411 Residential X
- Non-Residential
- Fee -$ 10.00 -
Septic Cesspool X
- NAME OF OWNER: Molly Trainor
OWNER MAILING ADDRESS: Clark Road
Southold. New York 11971
OWNER PROPERTY ADDRESS: Clark Road
Southold, New York
OWNER TELEPHONE NUMBER: 516-765-2696 '
TAX MAP NO. : Section 135 Block 2 Lot 5
CROSS STREET: Sound Avenue -
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing X
• Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: 1985
TcrI
Southold Town Clerk
DATE: August 21, 1987
(TOWN -SEAL)
OFFICE OF THE TOWN CLERK � �FFU(,(r .:
Town of Southold o�� -. CQG Application No. 9/7
Judith T. Terry, Town Clerk % n'
� `'"� �` • %C V Residential �
Town Hall, 53095 Main Road o g ?a
P. O. Box 1179 «l .' Non-Residential
Southold, New York 11971 Op‘.90$
Telephone -54 izat ��,
(516) 765-1801
TOWN OF SOUTHOLD
RECEIVED
`UG 1987SOUTHOLD WASTEWATER DISPOSAL DISTRICT
Town C4erk Southold APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 2%//
Fee $
DATE 9/7/ k1
OWNER NAME: (- ► -
OWNER MAILING ADDRESS: 64%—
OWNER
PROPERTY ADDRESS:14 d /. /17o �
OWNER TELEPHONE NUMBER:
TAX MAP NO. : Section /v) "9 Block - Lot
CROSS STREET: ç -cJ
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: l` 9g)5 ---
LOCATION MAP: Must be attached -hereto b c^e permit may be issued„
(Locate building and system; give north arrow and feet
of distance, approximately, to building and closest road.)
Signatur of Applicant
RECEIVED BY: �� L,Q
REC.. r . CL•rk's Office
DATE: AUG 21 1987
Town Clerk So )
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