HomeMy WebLinkAboutCassidy OFFICE OF THE TOWN CLERK ' cgitOL�(�►
Town of Southold
Judith T. Terry, Town Clerk A`.. �
Town Hall, 53095 Main Road 1 ��. t
P. O. Box 1179 u' •�u ' y {
Southold, New York 11971 t �
14",Telephone .'O1 411
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No 374 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool x
NAME OF OWNER: Andrew Cassidy _
OWNER MAILING ADDRESS: 1815 Albertson Lane , Box 193
Greenport, New York 11944
OWNER PROPERTY ADDRESS: 1815 Albertson Lane
Greenport, New York
OWNER TELEPHONE NUMBER: 516-477-1767
TAX MAP NO. : Section 52 Block 5 Lot 56
CROSS STREET: Colony Road
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: 1980
Judith T. Terry
Southold Town Clerk
DATE: July 29, 1987
(TOWN SEAL)
OFFICE OF THE TOWN CLERK .'PFFD
Town of Southold ���.: €. CQ Application No. 3-7Y
Judith T. Terry, Town Clerk •r , •
Town Hall, 53095 Main Road c,
.G Residential X
P. O. Box 1179 5 ` t <r.` �
' � Non-Residential
Southold, New York 11971 r. 1`
Telephone ( }'i
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
- for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
/ °sem
Fee
DATE artii a31 I/el
OWNER NAME: D&E) 010r�sloy
OWNER MAILING ADDRESS: tglci41._ ,ERtsonl (—I-svE
LENPoR1, • •
OWNER PROPERTY ADDRESS: 5A rn
OWNER TELEPHONE NUMBER: C5-l6) 177-- i'767
TAX MAP NO. : Section oZ Block Lot
COL b,v� � c"� - -� /
CROSS STREET: 44H-I-�1=1Zl'Sv N
6LIU QC—
TYPE
C—TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: 11Kd
LOCATION MAP: Must be attached hereto before permit may be issued.
• / (Locate building and system; give north arrow and feet
�- ,N LFF• N of distance, approximately, to building and closest road.)
451)1 ik.‘6 6.11/,`41q 412-Signature of App iant
A- ds
RECEIVED BY: G .c--
Town CI rk's Of ice
DATE: 17- ,.,2 y —��