HomeMy WebLinkAboutWhittier OFFICE OF THE TOWN CLERK • • FQ
Town of Southold
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Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road i a Asa w .
P. 0. Box 1179 `�, n
Southold, New York 11971 per`e' ''�= ff- ••
Telephone --701 NEA
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 430 Residential X
Fee $ 10.00 Non-Residential
Septic Cesspool x
- NAME OF OWNER: John R. Whittier M.D.
OWNER MAILING ADDRESS: P.O. Box 64
Orient, New York 11957
OWNER PROPERTY ADDRESS: 30 Northview Drive. Brown's Hills FctatPs
Orient, New York
OWNER TELEPHONE NUMBER: 516-323-3529
TAX MAP NO. : Section 13 Block 1 Lot 7
CROSS STREET: Browns Hill Road
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing x
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: August 1987
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Southold Town Clerk
DATE: September 18, 1987
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(TOWN ',,SEAL)
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OFFICE OF THE TOWN CLERK SW HU(
Town of Southold �� CS ',. Application No. O
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road c ."* Residential
P. O. Box 1179 u' x $ ,� Non-Residential
Southold, New York 11971 O . - ���'
Telephone : .( .1
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(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
fnr,
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ /Q
DATE -9 , �� 5 / 1;� rT
OWNER NAME: �„I . 1A-CM04- 14,4
OWNER MAILING ADDRESS: P,-(S k (,
OWNER PROPERTY ADDRESS: 3 b Ai cr,r'o r-C b r-jge,
r s, ', cl�� F o,C ?$ 7
OWNER TELEPHONE NUMBER: 3 z 7 -- 3 5'2.61
TAX MAP NO. : Section j 3 Block 'f Lot 7
CROSS STREET: 9 'r S 14s R..(744.
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing V"
Residential ✓ Non-Residential
- DATE OF PREVIOUS PUMP-OUT: v,y, I `1r j FI 817
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.)
Vigvv. RA kA/L: P1447
nature of Applicant
RECEIVEDCcs /
nal Town CIrk's Offibe
DATE EP 171997
Tow cork sow
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ls�pre rased,end on his behalf to tho
' ��LAND 5� tido company,governmental a0:moyant! ; '•"
lancing institution listed hereon atrl " - -
to thy avignoss of tho lending lnati- ' ,`
�,7 _e,/�� lotion.Guarantees aro not transferable, ;
rQ LK3d!ti3nal institutions or subsequMt - --,- _a,....,'-' • •