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OFFICE OF THE TOWN CLERK cl\FFOU(C,
Town of Southold �� ;� (4
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road
P. O_ . Box 1179 v' '
Southold, New York 11971Nr.
Telephone _ �l g,' �,;
(516) 765-1801 '
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 28 Residential XX
Non-Residential
Fee $ 10.00
Septic Cesspool y.
PERMIT ISSUED TO:
NAME: Edward B. Redhead
ADDRESS: 8380 Peconic Bay Blvd.
Mattituck, New York 11952
DESCRIPTION OF PROPOSED CONSTRUCTION or ALTERATION
New Residence
LOCATION OF PROPOSED CONSTRUCTION or ALTERATION:
OWNER OF PROPERTY: William and Mary Strickland
OWNER MAILING ADDRESS: 54 William Street
Hempstead, New York 11550
OWNER PROPERTY ADDRESS: 11900 Soundview Avenue
Southold, New York
TAX MAP NO. : Section 54 Block 6 Lot 17
CROSS STREET: Booth Road
BUILDING PERMIT NUMBER CROSS REFERENCE: Pending
•
Judith T. Terry
Southold Town Clerk
DATE: September 8, 1986
(TOWN SEAL?
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Southold, New York 11971
JUDITH T TERRY TELEPHONE
TowN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
September 8, 1986
Edward B. Redhead
8380 Peconic Bay Blvd.
Mattituck, New York 11952
RE: Wm. and Mary Strickland
11900. Soundview Avenue -, _
Southold, New York
Enclosed herewith is the Construction, Alteration or Modification
Permit for a Septic Tank or Cesspool System for which you applied.
Please be advised that each owner of real property operating an
on-site sewage disposal system, such as a septic tank or cesspool must,
prior to such operation, possess in the name of the owner an Operation
Permit for the system. The Operation Permit is issued by the Town
Clerk's Office.
The fee for an Operation Permit is ten dollars ($10.00) for
residential use and twenty-five dollars ($25.00) for non-residential.
' Please have the owner complete the enclosed Application for an Operation
Permit and return it to this office along with the proper fee.
For your general information I have enclosed an Informational
Bulletin regarding the Scavenger Waste Laws adopted by the Southold
Town Board. Should you have any questions pertaining to either permits
or the Scavenger Waste Laws, please do not hesitate to contact this
office. We will be glad to assist you in any way possible.
Very truly yours,
Judith T. Terry
Southold Town Clerk
Enclosures (3)
JTT/Ijc
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OFFICE OF THE TOWN CLERK
Town of Southold
Judith, T. Terry, Town Clerk Application No. (-33'
Town Hall, 53095 Main Road Construction
P. 0. Box 1179
Southold, New York 11971 Alteration
Telephone Residential
(516) 765-1801 Non-Residential
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
•
Permit No.
Fee $ /6
-�- /(°/ /g2'e
DATE
APPLICANT NAME:
APPLICANT ADDRESS: C 8"-ca ��-� 2. 63 7 lid ,
,/ / lQ64i�1,(. 1 �'�l. Y' l tx42.
SEPTIC /CESSPOOL
DESCRIPTI9N OF PROPOSED CONSTRUCTION OR ALTERATION
/-(x—A.J /-E-3 t cCA vtc
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: /'✓7'Y /14a-i-y `k �k 2,04
OWNER MAILING ADDRESS: -s`11 /le e51`/
F - &, /V.
OWNER PROPERTY ADDRESS: / /C o m c,4, tit, 4_i -d-g
TELEPHONE NUMBER OF CONTACT PERSON: eq g-i
TAX MAP NO. : Section (96-171 Block Lot /7
CROSS STREET: �e d +/-1 fraacc
BUILDING PERMIT NUMBER CROSS REFERENCE:
Signature of Applicant
RECEIVED BY: d-LzKd-�
Town Terk's ffice
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DATE: _d_r�/y),/46,<_, � / 9
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