HomeMy WebLinkAboutTuthill (9) OFFICE OF THE TOWN CLERK s cOFkir-
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of Southold � � �- G
Judith T. Terry, Town Clerk ,? f•14.
Town Hall, 53095 Main Road c a1F
P. 0. Box 1179 1 cn _
Southold, New York 11971 Q .� _r. !�,
Telephone 7_ ®1 y
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation_ Permit No. 588 Residential x
Non-Residential
Fee $ 10.00
Septic Cesspool x
NAME OF OWNER: John G. Tuthill
OWNER MAILING ADDRESS: 3310 Flijah's I ane -
Mattituck, New Ynrk 11957
OWNER PROPERTY ADDRESS: County Rt. 48
Mattituck, New York
OWNER TELEPHONE NUMBER: 516-298-8654
TAX MAP NO. : Section 108 Block 2 Lot 7
CROSS STREET: Elijah's Lane
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing x
• Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: December 1987 •
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Judith T. Tffry
Southold Town Clerk
DATE: January 27, 1988
•
(TOWN SEAL)
OFFICE 3F THE TOWN CLERK cOF01,-� ,,--��
Town of Southold �� - �Q Application No. 6 O
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road `�` , '� 7 Residential
cn "�
P. O. Box 1179 ,�� ;� �-'z �z Non-Residential
Southold, New York 11971 O ® ' • z",�`�
Telephone .(
-47
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ f@
DATE 40.).A-R y A7/ I?Sr-
OWNER NAME: el,14 NI tf;, / I,rT,t�l�L
OWNER MAILING ADDRESS: /3/9 .5j_jj4.4
OWNER PROPERTY ADDRESS: y ,/�7- AQ ,S�`
� iJ%413 i-A/t
OWNER TELEPHONE NUMBER: S'1, 029 141! 41'
TAX MAP NO. : Section /0 Block Lot 7
CROSS STREET: Q..,d ca, `&-
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential — Non-Residential
DATE OF PREVIOUS PUMP-OUT: 6s.A_ / 9°fl7
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.)
ature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
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