HomeMy WebLinkAboutWilliamson ''l11/�yeo%%I/1 .,�'i
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veo.„ Town Hall, 53095 Main Road
JUDITH T. TERRY _
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TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER ® O ��� Fax (516) 765-1823
„0— Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3047-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner WILLIAMSON, LOUIS A.
Mailing Address 1 710 BROWN STREET
Mailing Address 2
City St Zip GREENPORT NY 11944-0000
Property Address 1 710 BROWN STREET
Property Address 2
City St Zip GREENPORT NY 11944-0000
Owner Telephone No. 516-477-8518
Tax Map No. section 48.00 block 3 lot 23.000
Cross Street SEVENTH STREET
Date Of Last Pump Out 0/00/00
Issue Date: 6/28/93 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF 7,i,HE TOWN CLERK 9cOMA'-..„' Application No. 30 //
Town of Southold �% CQ ' pp i 7
Judith T �erry, Town Clerk ' ;* ? `� $10.00 - Residential ��
Town Hall, 53095 Main Road it
P. O. Box 1179 tri 3,,.-,44,?;;- Z $25.00 - Non-Residential
Southold, New York 11971 OO ' ''`,
Telephone 64. N"."
•
: .(
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE io /A/ /51,7
OWNER NAME: . /7L1.J...4„eet_e__„i_o_27,L.
OWNER MAILING ADDRESS: 7 jo &D c.)•-t.) Si-/
�' )1 . ``,' q
OWNER PROPERTY ADDRESS: 710 i , ,
J'T4PL �`1;—
OWNER TELEPHONE NUMBER: ( i ) Tt 76'
1 TAX MAP NO. : Section '! p Block 3 Lot Q.-.3
CROSS STREET: 444 '
TYPE OF SYSTEM: Septic Tank // New Existing ye_g
Cesspool New Existing
Residential LZ Non-Residential
DATE OF PREVIOUS PUMP-OUT: i747 3 l 7?3
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.)
ft/1 N. xi. .....0:AIL.„7„,4,:rz_t
Signature of Applicant
RECEIVED BY: , ."--1-246-1--------L
/ own Clerk's Office
DATE: 6 (2-( ( 73
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