HomeMy WebLinkAboutCottral OFFICE OF THE TOWN CLERK • Fo'`
Town of Southold ®��� "O
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road a *$ ,;
P. 0. Box 1179 vs •? :, :461;.1,.3 ,•
Southold, New York 11971 ir.' :
Telephone /) i
(516) 765-1801 •
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TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 221 Residential x
Non-Residential
Fee $ 10.00 '
Septic Cesspool X
NAME OF OWNER: George E. Cottral
OWNER MAILING ADDRESS:. Box 15
Greenport. New York 11944
OWNER PROPERTY ADDRESS: 15 Sutton Place
Greenport, New York
OWNER TELEPHONE NUMBER: 516-477-0203
TAX MAP NO. : Section 33 Block 5 Lot R
CROSS STREET: Sunset Lane
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing x
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: Unknown
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Judith T. Terry
Southold Town Clerk
DATE: February 11 , 1987
(TOWN 'SEAL)
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OFFICE OF THE TOWN CLERK C.OFO(,r
Town of Southold 041„-- Application No. o2,2,l
Judith T. Terry, Town Clerk y
Town Hall, 53095 Main Road " AG Residential
P. O. Box 1179 cn '' i ;' Non-Residential
Southold, New York 119710 .» ' J o •�`�
�® ,�•
Telephone _ .(
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ ( Q,,, 60
DATE o2 1b1R7
OWNER NAME: )1(LA eitjr (01
OWNER MAILING ADDRESS: 1Q- ) A (1 .
If9e-`te,
OWNER PROPERTY ADDRESS: 1, S_L.,Mr(r1c se 5/.._
OWNER TELEPHONE NUMBER: ti77— 0 0
TAX MAP NO. : Section ,3 3 Block £ Lot g
CROSS STREET: S �� N p
TYPE OF SYSTEM: Septic Tank New / Existing
Cesspool Z New Existing
Residential %LA./ 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.)
Signature of Applicant
RECEIVED BY: " `4"
RELLMA Jerk's OfficejN
DATE: FEB 1 0 1987
Town Cwrk Southold