HomeMy WebLinkAboutTuthill (8) OFFICE OF THE TOWN CLERK • •S�FFO[K0�
Town of Southold �O �G
- Judith T. Terry, Town Clerk � ' - - -
Town Hall,. 53095 Main Road
P. O. Box 1179 ,•n ,� •
Southold, New York 11971 - - p ' . ••
Telephone _ 1
(516) 765-1801
- TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC. TANK or CESSPOOL
Operation Permit No. 419 -Residential x ;;)
Non-Residential ,1
- Fee $ 10.00
Septic Cesspool X `n
NAME OF OWNER: Harry Tuthill
OWNER MAILING ADDRESS: 115 Youngs Avenue
Mattituck, New York 11935
OWNER PROPERTY ADDRESS: 115 Youngs Avenue
? ,
Mattituck, New York
OWNER TELEPHONE NUMBER: 516-298-8298
TAX MAP NO. : Section 114 Block 10 Lot 31
CROSS STREET: Pine Street
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: June 1987
I... +h T Terry
Southold Town Clerk
•
DATE: September 2, 1987
(TOWN SEAL)
OFFICE OF THE TOWN CLERK §FFp
Town of Southold �QS CQG'; Application No'WC,
Judith T. Terry, Town Clerk er :
Town Hall, 53095 Main Road Residential
cn .
P. O. Box 1179 '` � Non-Residential
Southold, New York 11971 O ® fi rOg'�'�
Telephone4.1
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. /#7
Fee $ /C. re)
DAT4,n O /M-7
OWNER NAME: '41.. g` AAlt /
OWNER MAILING ADDRESS: // ,C2 c( 6/e4
/994-7-1r o /42-V' //
OWNER PROPERTY ADDRESS: , g / 'TI Q�j a
71,9 '- / -0 ® ✓e / / -! S _
OWNER TELEPHONE NUMBER: 0278,- 62a. q2
TAX MAP NO. : Section // ( Block / C Lot
CROSS STREET: 07,,, JL 1
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing 1/
Residential Non-Residential
- DATE OF PREVIOUS PUMP-OUT: p 7r7
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.)
Si./atu e of Applic•nt
RECEIVED BY:
Town Clerk's Office
DATE: