HomeMy WebLinkAboutZimmerman f 00 7g- 1t,
L • z . ��. Town Hall, 53095 Main Road
t. A14'4116000 S:74 P.O.�. i�' P.O. Box 1179
sem, �,� Southold, New York 11971
JUDITH T.TERRY
Vie c2 FAX FAX(516)765-1823
"��� TELEPHONE(516)765-1801
TOWN CLERK
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 1212-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner ZIMMERMAN, THOMAS J.
Mailing Address 1 87 KAROL PLACE
Mailing Address 2
City St Zip MUTTONTOWN NY 11753-0000
Property Address 1 265 ROCHELLE PLACE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-5075
Tax Map No. section 144.00 block 4 lot 9.000
Cross Street BAY AVENUE
Date Of Last Pump Out 0/00/00
Issue Date: 8/09/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
o 'S.
OFFICE OF THE TOWN CLERK cOFOINA-
Town of Southold %p j C'� = Application No. 703/ 2--`
Judith T. Terry, Town Clerk ‘ =MI , �''`'`
Town Hall, 53095 Main Road "` " :G } $10.00 - Residential �/
�2 , _
p, O. Box 1179 u' '-i-A �` $25.00 - Non-Residential
�Y i -i-ATA-p-viz,
Southold, New York 11971 O ®H�'t`-' -0-I°.
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Telephone 461)1415-
of ,
(516) 765-180144 P
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ /a;�
DATE if UGUi 7- /9f
OWNER NAME: ///o,114.S Z/4,1 m glum.4/ • .
•
OWNER MAILING ADDRESS: 7 &AJe®L Pz_Aa �"
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A /4 7 T o Av'r P WA /V 1"� /17.E 7
OWNER PROPERTY ADDRESS: 026-sr' oc.Ule'L.Z1.2- ?Z.4C
_ M A YT) TU c e)-&jti .2.
OWNER TELEPHONE NUMBER: j,?-- 1/45-d75-)
TAX MAP NO. : Section /5/V Block V Lot 9
CROSS STREET: 6A)-' 4 VEv ie
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool f New Existing
Residential ✓ Non-Residential
DATE OF PREVIOUS PUMP-OUT: guL)'} M9
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.)
Si,,,---7/71
n ur of Applicant
RECEIVED BY: '
• Clerk's Office
DATE:
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cERrIF1r_u TO ; SURVFY FOR
TITLE U. S. A. INSURA NCE THOMAS ZIMMERMAN
CORPORATION OF NEW YORK AT MATTI TUCK •
TITLE ' NO. 8652 - 54456
LIBERTY MORTGAGE TOWN OF SOUTHOL D
BANKING LTD. SUFFOLK COUNTY , N. Y
THOMAS• ZIMMERMAN 1000 - 144 - 04 - 009 .
•
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1 • SCALE I " a1 40 '
APR. 4 , 1986
LOT NOS. REFER MAP OF PROPERTY OF
LIDA BARTLEY' FILED IN THE OFFICE OF THE . . •
SUFFOLK COUNTY CLERK ON JULY 27,19 22 AS •
MAP No.77s�P��OF Nei .
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Y.S. LIC . NO. 49618
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P. 0. B 0 X 90 9 bur such uro t,y Tho New York Sfote Land
M A I N R 0 A DTitle Association.
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