HomeMy WebLinkAboutWilliams (3) OFFICE OF THE TOWN CLERK ' �
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Town of Southold c .rte. - CD
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road .='
P. O. Box 1179
Southold, New York 11971
Telephone _•01 is
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 73 Residential 73
Non-Residential
Fee $ 10.00
Septic Cesspool XX
NAME OF OWNER: Mr. and Mrs. Howard E. Williams
OWNER MAILING ADDRESS: 1605 Shore Drive
Greenport, New York 11944
OWNER PROPERTY ADDRESS: 1605 Shore Drive
Greenport, New York
OWNER TELEPHONE NUMBER: 516-477-0214
TAX MAP NO. : Section 47 Block 2 Lot 31
CROSS STREET: Walter Avenue
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool XX New Existing xx
Residential xX Non-Residential
DATE OF PREVIOUS PUMP-OUT: August 1986
Judith T. Terry
Southold Town Clerk
DATE: September 30, 1986
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OFFICE OF THE TOWN CLERK of _
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Town of Southold �� CQG Application No. 7-3
Judith T. Terry, Town Clerk . fib
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Town Hall, 53095 Main Road o _ �" '< Residential
P. O. Box 1179 cry ' Non-Residential
Southold, New York 11971
Telephone
(516) 765-1801
RECEIVE) TOWN OF SOUTHOLD
SEP 3 0 1986 SOUTHOLD WASTEWATER DISPOSAL DISTRICT
Town Clerk Southold
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. Z3
ti
Fee $ // '`
DATE 7./. ,./g
OWNER NAME: ME, las //0l� A eip 4//��1f w-S'
OWNER MAILING ADDRESS: aoc--- ...C/4/ 7dZ
6;4'eWrG 4/ /73/
OWNER PROPERTY ADDRESS: s /1 "Pie AS 9.6a i/ `e
OWNER TELEPHONE NUMBER: �' >� 4/77 —per/ x/77--oa /5/
TAX MAP NO. : Section/000 L/7 Block Lot 3j L# q ('(1
iT+'MNo
CROSS STREET: C--
TYPE
✓TYPE OF SYSTEM: Septic Tank / New Existing
Cesspool 1/ New Existing
Residential dental Non-Residential
DATE OF PREVIOUS PUMP-OUT: AM/ NkG
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.)
Signature '6f Applicant
RECEIVED B Y: 6kc6c-- C!9- /L)
Town Clerk's Office
DATE: Aemco-ei ) /2 ,P67
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