HomeMy WebLinkAboutTuthill (6) OFFICE OF THE TOWN CLERK ' S��FOL4-
Town of Southold -
Judith T. Terry, Town Clerk � 1
Town Hall, 53095 Main Road c
P. O. Box 1179 v'
Southold, New York 11971
Telephone 0;".
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(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 39 Residential xx
Non-Residential
Fee $ 10.00
Septic Cesspool xx
NAME OF OWNER: Joyce Arnold and David B. Tuthill
OWNER MAILING ADDRESS: P.O. Box 48
Mattituck, New York 11952
OWNER PROPERTY ADDRESS: 2170 Deephole Drive
Mattituck, New York
OWNER TELEPHONE NUMBER: 516-298-8340
TAX MAP NO. : Section 123 Block 4 Lot 7
CROSS STREET: New Suffolk Avenue
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool xx New Existing xx
Residential xx Non-Residential
DATE OF PREVIOUS PUMP-OUT: November 1985
Judith T. Terry
Southold Town Clerk
DATE: September 8, 1986
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK ,S c0FCurCS.
Town of Southold ® , G Application No. (._"7 .
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road '" .G Residential
P. O. Box 1179 c.r3 ' _ : Non-Residential
Southold, New York 11971 O ® ,
Telephone .(
•
(516) 765-1801
RECE9VE® TOWN OF SOUTHOLD
SEP 0 31986
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
Town Clerk Southold
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. (3/
Fee $ /6 '
DATE ,4u � mfe6
OWNER NAME: AgNoL/L 44/0 D,4ur i , --/'677-4/CC
OWNER MAILING ADDRESS: 8o) 4S A-77/7uc
OWNER PROPERTY ADDRESS:
/14,4 7 T/7'v G,-- A/.
OWNER TELEPHONE NUMBER: 5/6 - Z9$ -8 3 440
TAX MAP NO. : Section Block 44 Lot 7
CROSS STREET: 1 ,o
TYPE OF SYSTEM: Septic Tank X4. New Existing )(
Cesspool New Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: NO v /5/05
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:
Townrk's Office
DATE: -'
MEWED
SEP 0 8 1986
rninin Clerk Southold
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