HomeMy WebLinkAboutTuthill (2) / a
JUDITH T. TERRY /4 r4 Town Hall, 53095 Main Road
TOWN CLERK Z. O Fri
P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER 210. Off'
Fax (516) 765-1823
�1� �� Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3019-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner TUTHILL, DONALD E. AND LORNA E
Mailing Address 1 3150 BOISSEAU AVENUE.
Mailing Address 2
City St Zip SOUTHOLD NY 11971-0000
Property Address 1 3150 BOISSEAU AVENUE
Property Address 2
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 516-765-3652
Tax Map No. section 55.00 block 6 lot 8.000
Cross Street YENNECOTT DRIVE
Date Of Last Pump Out 1/06/83
Issue Date: 5/14/93 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERKS�FFp� �o /PTown of Southold �� - CQ Application No.
Judith T. Terry, Town Clerk kY `� $10.00 - Residential
Town Hall, 53095 Main Road
P. O. Box 1179 u' _ VO:'.?_
$25.00 - Non-Residential
Southold, New York 11971 O }' ~ P
Telephone *tag'
(516) 765-1801
TOWN OF SOUTHOLD -
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. S C 17
Fee $ D�
DATE 5 - 7- 73
OWNER NAME: DONLD E. 4 L()RNA E, yu 'T H (L L
OWNER MAILING ADDRESS: 31 5-0 BO1s5E4v
SoOT(4 ,1J2 NV 11 77/
OWNER PROPERTY ADDRESS: 5/11415"
OWNER TELEPHONE NUMBER: 516 ` 765' 36 -5-2-
TAX
65' 363 2-
TAX MAP NO. : Section 0515— Block 6 Lot
YE/VIUEcor r DcMf UE ✓'
CROSS STREET:
TYPE OF: SYSTEM: Septic Tank New Existing ✓
Cesspool New Existing Y
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: I — 6 -
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.)
S. �� ALe_e___,
Signature of Applicant
RECEIVEDB Y: G1--
Town Clerk's 0 fice
DATE: �����
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