HomeMy WebLinkAboutMcCaffery OFFICE OF THE TOWN CLERK $ 'Of Niro;
Town of Southold Q
Judith T. Terry, Town Clerk •
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Town Hall, 53095 Main Road g 1 A
P. 0. Box 1179 `tn ��-i
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Southold, New York 11971 ,�` _•' � •
Telephone : 1 t
(516) 765-1801 _
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 195 Residential x
Non-Residential
Fee $ 10.00
Septic Cesspool x
NAME OF OWNER: Patrick J. and Kathy M Caffery
OWNER MAILING ADDRESS: P.O. Box 257
Orient, New Yo',rk 11957
OWNER PROPERTY ADDRESS: 1570 Village Lane •
Orient, New York
OWNER TELEPHONE NUMBER: 516-323-2435
TAX MAP NO. : Section 24 Block 2 Lot 15
CROSS STREET: Prciard Street
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing x
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: July 1986
Judith T. Ter
Southold Town Clerk
DATE: January 7, 1987
(TOWN SEAL)
OFFICE OF THE TOWN CLERK COFUL' -
Town of Southold �� CQG Application No. ��y'
Judith T. Terry, Town Clerk ? `. t
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Town Hall, 53095 Main Road a� x : Residential
P. 0. Box 1179 .` Non-Residential
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Southold, New -York 11971 t
Telephone
. 1 , .
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. /95
Fee $ ,)(7 a.c
DATE (- 7- 3-1
OWNER NAME: PAT/la- J_ or K-lld4 NA, GA VP _4(L('
OWNER MAILING ADDRESS: /O QY- c .7
OIZA`?AUT`` Ivy 11Q5"-7
OWNER PROPERTY ADDRESS: i '7(-) V1 LLAcT,E Li
OR-taN"+ INC)
OWNER TELEPHONE NUMBER: 323-• -435
TAX MAP NO. : Section `: -f Block c=2-- Lot IS
CROSS STREET: 1rchc3C4 S�
TYPE OF SYSTEM: Septic Tank New Existing \-Y"
Cesspool J New Existing
Residential \/ Non-Residential •
DATE OF PREVIOUS PUMP-OUT: Jail /clop
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.)
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naturApplicant
RECEIVED BY: I 4.4 ;go
ecevoTown CI: k's Off'e
DATE: AN 07 1987
Town Clerk Southold
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