HomeMy WebLinkAboutTuthill (7) �1, L .r Town Hall, 53095 Main Road
JUDITH T. TERRY .;� . . •
TOWN CLERK ® • s, P.O. Box 1179
REGISTRAR OF VITAL STATISTICS �,' u s _ �� Southold, New York 11971
MARRIAGE OFFICER P �. �� Fax (516) 765-1823
_�®` ® $. Fax
(516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 1625-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner TUTH I LL, SHERR I L AND HAZEL
Mailing Address 1 506 BAILEY AVENUE
Mailing Address 2
City St Zip GREENPORT NY 11944-0000
Property Address 1 506 BAILEY AVENUE
Property Address 2
City St Zip GREENPORT NY 11944-0000
Owner Telephone No. 516-477-0363
Tax Map No. section 34.00 block 4 lot 13.000
Cross Street CHAMPLAIN PLACE & NORTH ROAD
Date Of Last Pump Out 0/00/00
Issue Date: 2/20/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
,s
• v..
OKR'`ICE OF THE TOWN CLERK �c \VFIJFL - )/
Town of Southold Q 0 % Application No. / 6,9
Judith T. Terry, Town Clerk . ,` A y
Town Hall, 53095 Main Road `" '�" '4„ -4 $10.00 - Residential
P. 0. Box 1179 cryilt V % $25.00 - Non-Residential
Southold, New York 11971 Q �$
Telephone OI `1\�� e.• �
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION ,
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE 2--�,-, / / /
OWNER NAME: .1_e_ ' 2C2.,(S .e./�r�.c, .D�"
OWNER MAILING ADDRESS: ..__5-0 ' t CZ,--.e, ,
.- --4 .e_, yr /17- --*/
OWNER PROPERTY ADDRESS :
OWNER TELEPHONE NUMBER: _5 / G -- o ,s
TAX MAP NO. : Section ' .3 V Block iI Lot / ,5
CROSS STREET: .t9„.,i,, �� -7--,
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New X Existing
Residential Ne Non-Residential
DATE OF PREVIOUS PUMP-OUT:
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.)
/ LS � &
Si. •ature of Applicant
RECEIVED BY: c.v.t.y,c ______-e
Town Clerk's Office
DATE: g/-2,017
f
'TivIMMIELIMERIE !!'"'"0", •ri)prairmumennumtun
_.., ..................., „, • -- , - , _ , .......................
ismullaulimull .. t.,..1111, 1. 1117/ mIllm !mms-mmummomm
....
.........................75- ... , ..... ......... , ...., ...
1.........inbsstalp....r........v.....%4 i 4.1.4.1.14...m......a ...1.1 ........._.......d
............................. ........ ............. MIIIM WI _ ME
1111111111MMEM MUM BM IIM FM= =ME= MEM _ME UM . MEnn
NEWILMMEM . • MEE Mismill 1M MEMIMMII Mir • .J., _ r ,T, N.
MOM MMOMMIMENRIMMEMON1141111117 ME 1 IEEE"
11. 1111111111.111 MIIIIIILIM MINIM 111111111 IMLR_I MIIIII
-�e��II
II IM ME MN II • II OM 10111 MO
RIPPRIMMILIP-11-191.. aiEL. 2.pi:Rin....i. ..
_,71
............11......, :IIIII ... _ 7,L J4,„„, ............. ....
....,....... Immin F ' , i . - '_. MUMMIMMEMMEMEM =MEE
. pe.iiiir Mgr • iss _ 1 In / rinum•••••••Bnagn
Mininnomninirrnanniiiiiii I _I: MI, Ejr_ / Mrnallintra Mannininrn
IlmmidIMM:1 mIll • • mammIMMONIMMWTMUMMILIM
' w MMEmmmmEMIUmmEMMI:m M MEM= OmmmmEMMINIMMMEMEMMEmmlIMMOMMEMEM
.W \ 111111011MIMMIIMMOMI MEM millIMMEMEM iiiiMMEMMEMMEMIMMEIMMEMMMEMEMM
IrM
1 irilliMMIIMIIIIIMIIIIIIIME MEW IIIIIMIIIIIMIIIIIIIIIIIIIIIIIII
11
ii
v00
v.......... . ... pormimmm...0402.. ............................nN� ■ �
. MMEMMEMMEMIOMMMEM g • MEM MEM llt MEMMEMMIMIMMEMMINIMMIUMMIIMEMIM ,
EMMUMUMMEMMEMMOM Iv MI// 111.3111= f IMONIIMMEMMIMMEMMEMMEMM.16..ZION \,
�I��I �■p�IIIIIIIIIIImmull � SII
111 IIIIIIIIIIIIIIIIIIIIIIIIIIIII1
................... ...... • ..... .. MMEMMIIIMMEMMUMMEMEMIUMMEMMEMOM
EMMOMMEMIIMMEM MEM
II
1111111111111 III 111111111111 11111,111111111111111111111111111111 t
11
ELEMENNEILLEIMP"C'
!iH1111iiHHH11111Hi11111H11iH1HHii11iH1iHHHHiHHi111Iiiu �
I' II ! II I