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Home My WebLink AboutCancro '5-. 2 OFFICE OF THE TOWN CLERK 6FU Town of Southold ��{; COQ Judith T. Terry, Town Clerk y*" Town Hall, 53095 Main Road fee .-:;-t P. O. Box 1179 cn Southold, New York 11971 _py®" ° • O� •` Telephone = "'�1 „� (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 336 Residential X Non-Residential Fee $ 10.00 Septic Cesspool x NAME OF OWNER: James and Johanna Cancro OWNER MAILING ADDRESS: 4515 Pequash Avenue Cutchogue, New York 11935 OWNER PROPERTY ADDRESS: 4515 Pequash Avenue Cutchogue, New York OWNER TELEPHONE NUMBER: 516-734-7486 TAX MAP NO. : Section 137 Block 4 Lot 5.2 CROSS STREET: Stillwater Avenue TYPE OF SYSTEM: Septic Tank New Existing Cesspool X New Existing x Residential X Non-Residential DATE OF PREVIOUS PUMP-OUT: Unknown Judith T. Terry Southold Town Clerk DATE: , July 15, 1987 • (TOWN ,SEAL) III „-'' OFFICE OF THE TOWN CLERK c0FO- Town of Southold �� "-' .. CQG'_ Application No. 3,-9 Judith T. Terry, Town Clerk ' rin11� Residential Town Hall, 53095 Main Road P. 0. Box 1179 u3 -. i' ` `' �� , � Non-Residential Southold, New York 11971 ® Telephone _ j4.1 ' (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ 0 DATE OWNER NAME::114i} E S 4-- a r\ A C-AdpiC kO OWNER MAILING ADDRESS: Li TP-e)9 L, AS I-) A I) u D D1 u e A"N./ //%. 5 OWNER PROPERTY ADDRESS: 11 OWNER TELEPHONE NUMBER: 1 3 (-,{" -)61- j3"7 TAX MAP NO. : Section ) j Block © � CROSS STREET: 5+i d ( ua A - e 0 A e TYPE OF SYSTEM: Septic Tank New Existing Cesspool New Existing 9� Residential Non-Residential DATE OF PREVIOUS PUMP-OUT: 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.) Javan nt T .7"--- Signature of Applicant RECEIVED BY: Town Clerk's Office DATE: ...(____4 ' f q /J /� C,Ci�J ° _ •b""".,. _ l). ° J • I i j 0 f , i c.or Is -, ;(' , 0 M. 5T°45'C)C r La. • .ti • 0 D �• 16 ) 0 CaT 11 - ,4,tj „— 4 1 ' x' Cess pep/ Y m OC L_ -- , 1 �.a -� = o c , G 1J • I— a �� i ,,- ,,•, '_. 0- 'J { I-- Z J 1! , Ikgz' a d .. _. 6.57°45'C)cp"w. — II 1' C N . C/kALI: -.-.3 C1 1" ? a I iC'r31%I y: h:". I IAP Or r orL�,cTY . 5l1lz,v--yt-m +-nom `31'T U AT IE" AT . ' CLJTCi1OC-ILJ6.`• Tow NJ 1; r. WC)LITt•IC L0 •1.4.Y -- --- , ® NC)TL LINAUTNORIZED ALT:..A"nCy ne AJDITioN IL®T KILik•fib0-Re3 c3I-ICJW N A -r-LLik Tc) w/AAr CT- ia-L3T tb'. ; 7c)D To THIS SAW IS A 1,-LA.:C.N or � '[y L C SIL', C.11-7-117:.(1- £.ECTtON 7:C9 Cf t;..1�ti' Y(..1.�S. Coy*. " ialLLNI IN T'1°1 la�q',Writ-06.K ecui.-� EDUCATION LAW. 8" 114L1/NP-45-till-45-tillII6 t.�P NCT pEAGINO _.. __. _ - --- _ . _—T - - - - - --__- COPIES Of 71115 EUi�••'' r. Oft LA'D VESED:C : v:•. �: ;,SID:t10 t2Yu.t\MANTC-br) TO 71'11!.- A/Ad-RICAN TITLE.- ? i 's ,TOL6t A VA,2 ,._a C27,.. L. :✓ 41•,KL.JFbANCLa C0. 114411 TO TI•1 gtJ1 :I .r';A - 'I':�`Ia NIA POI PU'r?Lfktili. til/AWMI et LCT�,N As,c3C,C'liA iC,r-4 ONLY 1:TL:S 1V:.::1. %,'..W. hii„yYtl6T j C. ONLY lv i,::� J,1,t..0. �, I,,TIT; gt,JRYLIIYa-P?11® JULY 9, I 7.4 F. ' 1$P&t7 Atlo. _ p p.� ►q p `'p q� p� TCR[CvM:AKY,c,-.4:.v.„ .;,tit 1 ' Ko D e-m i c Y A N 1 la� ° L p ( . 4 . II To• rra D ZeKr-la. PNZ 1,-;09..-9''...%:, ,' T>Y>'�I- ° ,Z, V Tb TEH A.w.:IDR�6.T NZ - ;o ,ra +w a Liw Nler) Lnandr' 51.7and1"ioPks Ptoww .. _ CdYo4° c+1l.e-o-Npr° I� york1�