HomeMy WebLinkAboutColligan fell
611914
1191 �� 0037,
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Town Hall, 53095 Main Road
P.O. Box 1179
=O� ® i! Southold, New York 11971
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JUDITH T.TERRY ��=�®` ��.!�l,`l, 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. 1338-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner COLLIGAN, FREDERICK
Mailing Address 1 829 CAMINO ROAD
Mailing Address 2
City St Zip DELRAY BEACH FL 33445-0000
Property Address 1 520 PARK AVENUE EXT
Property Address 2 BOX 270
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 417-272-1769
Tax Map No. section 123.00 block 8 lot 28.004
Cross Street BUNGALOW LANE
Date Of Last Pump Out 0/00/00
Issue Date: 12/08/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERKh
Town of Southold C Application No.
Judith T. Terry, Town Clerk
4' 1' �~ y
Town Hall, 53095 Main Road '<` ` `x �C $10.00 - Residential
P. 0. Box 1179 cn x '�` 3v=.
jw $25.00 - Non-Residential
Southold, New York 11971
Telephone :Q( 1*
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(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE 11/26/89
OWNER NAME: Frederick Colligan
829 Camino Rd.
OWNER MAILING ADDRESS:
Delray Beach, Fl. 33445
OWNER PROPERTY-ADDRESS; 520 Park Ave. Ext. (Box 270)
Mattituck, N.Y.
OWNER TELEPHONE NUMBER: 298 ta2t 417 272 1769
9490
v TAX MAP NO. : Section /•023 Block Lot c,2
ROSS STREET: c)
TYPE OF SYSTEM:- Septic Tank X New Existing X
Cesspool - New Existing y
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: 8/21/89
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 nature of A licant
Peconic cesspool wa to have obtained
permit. Encl. Permit Fee of X10.
However, location maps are in Mattituck
RECEIVED BY: and not obtainable until May. Perhaps
own Clerk's Office Peconic Cesspool will give you the
' EC�9'.=`=1 location.
DATE: DEC G`;
Town Clerk Southold
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