HomeMy WebLinkAboutTurner L
� �� Town Hall, 53095 Main Road
%0 .J P.O. Box 1179
------_,R,/ 44 �`°•06° Southold, New York 11971
JUDITH T.TERRY '� �„'//oo° 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. 669-R Residential X Non-Residential
Fee $ 10. 00 Septic Cesspool X
New Existing X
Name Of Owner TURNER, MICHAEL J. AND BETTY A
Mailing Address 1 425 NINTH STREET
City St Zip GREENPORT NY 11944-0000
Property Address 1 425 NINTH STREET
City St Zip GREENPORT NY 11944-0000
Owner Telephone No. 516-477-9538
Tax Map No. section 48. 00 block 1 lot 27. 000
Cross Street CORWIN STREET
Date Of Last Pump Out 11/00/86
Issue Date: 4/18/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK c$FD/pr
Town of Southold �® - - v �� ' . Application No.�(�7
6.
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road I Residential
P. O. Box 1179 v' 7
>;. i Non-Residential
Southold, New York 11971 ® ' ao�''`
Telephone : .� r3INN
•
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE p,pg►w I i 14 gg•
OWNER NAME: IAlegArL �, BEI i`t A. TugrdCR
OWNER MAILING ADDRESS: HI“ f1,
GiZEfNPon-t NY 1, 9~44
OWNER PROPERTY ADDRESS: ti 1,s• S'f,
CM-WO ci-i, My it g w �1
OWNER TELEPHONE NUMBER: (II,- %.0-1_611-3 $'
TAX MAP NO. : Section g. Block l Lot 17
CROSS STREET: 6o a w i to S'f.
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing ✓
Residential V Non-Residential
DATE OF PREVIOUS PUMP-OUT: N cid, 1 At6
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.)
NAA Scui
SignaturJ of Applicant
RECEIVED BY:
Recils9 Clerk's Office
DATE: (SPR 1S 1•
low Cloth Southold
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