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HomeMy WebLinkAboutWennerholm r orr JUDITH T.TERRY �� r Z, • Town Hall,53095 Main Road TOWN CLERK J P.O.Box 1179 r° 0 � Southold,New York 11971 REGISTRAR OF VITAL STATISTICS . 6 MARRIAGE OFFICER � ® i� Fax(516)765-1823 RECORDS MANAGEMENT OFFICER ®l 0 ��,d� Telephone(516)765-1800 FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 3250-R Residential X Non-Residential Fee $ 10.00 New Existing X Name Of Owner WENNERHOLM, EDWARD Mailing Address 1 49 TRAFALGAR SQUARE Mailing Address 2 City St Zip LYNBROOK NY 11563-0000 Property Address 1 650 BAYVIEW AVENUE Property Address 2 City St Zip SOUTHOLD NY 11971-0000 Owner Telephone No. 516-593-9235 Tax Map No. section 52.00 block 5 lot 42.000 Cross Street COLONY DRIVE Issue Date: 9/09/94 Judith T. Terry Southold Town Clerk (TOWN SEAL) J,rt , ". O-ICE OF THE TOWN CLERK �FFO Town of Southold �� . �O -_ Application No. ,3�673 Judith T. Terry, Town Clerk y Town Hall, 53095 Main Road I $10.00 - Residential P. O. Box 1179 cn { ni .` $25.00 - Non-Residential Southold, New York 11971 Telephone = ( ' (516) 765-1801 TOWN OF SOUTHOLD itIOAVID SEP 9 1994 SOUTHOLD WASTEWATER DISPOSAL DISTRICT Town Cie* 6opthcf APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL • Operation Permit No. Fee $ /v DATE e— OWNER NAME: O wt426I We Uofle(AvlvA OWNER MAILING ADDRESS: � � (g/}r'yr 6 iZ S cuAv2 li1[ ook A,y, 05(03 OWNER PROPERTY ADDRESS: 5 Loot U tett) 14-)^t Sb oteA61 OWNER TELEPHONE NUMBER: '51 2)-9 Z3J TAX MAP NO. : Section Block 5 Lot L v CROSS STREET:- CO 6.-0/v7 y >Or a t. TYPE OF SYSTEM: Septic Tank New Existing Cesspool x New Existing Residential Non-Residential 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.) h(a4, (04602 Signature of Applicant RECEIVED BY: \ Town Clerk's Office •'( DATE: . , , , 4 ' , . ,.._ - . 70-,_,-D. - __E-,-s ,...;„_,..,...,__ _ ______.,.________,____________ . . _ _.. ... .. . . „ , . ._,.__, . ,..... . . ______ . . .,.. .. _ .. . . . . . . , . , , . . .,_0 . , , , ,,..„. . . , _ , , . ., ... . _ ,... . . ., . , . , „ : , „ , , ,, .,. . _ , . . . . , , . FE ET. . , , 1", - ,.. , . _ . . . . ,. . . . . . . , . , , :I, _ — - - . _ ., - , k L-24q,C - , /hr'101 'LOTS' Ss y A-N_b xv , `;S�-Nr�E(Zktv'�=r.1 KAT J 133, •' , , . - , , - -`` "j----- -z_ . ' ---.--,• ,•,44"1- ---•--, ,„y. . , - ',- . ,. • mow';,,, ,, •�p_�� c .1%PA't,(cf.;, �L ',=r`� - •- - fir''' " 5 �5:�* .� �'L,�,! L ^i_ e // i CF ' ; U rst • • ��a� • d®rpm I_-'; • � ,, `- :•- f\, - , , _5 STREr T