HomeMy WebLinkAboutCowan OFFICE OF THE TOWN CLERK 'Of ouri:-
Town of Southold _ -. �G
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road =o '. jr�
P. O. Box 1179 h,..'
Southold, New York 11971 Oj. ����''
Telephone x.101 $
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 309 Residential x
Non-Residential
Fee $ 10.00 Septic Cesspool X
NAME OF OWNER: Cowan/Jester
OWNER MAILING ADDRESS: P.O. Box 87
East Marion, New York 11939
OWNER PROPERTY ADDRESS: 9795 Main Road
East Marion, New York 11939
OWNER TELEPHONE NUMBER: 516-477-1808
TAX MAP NO. : Section 31 Block 4 Lot 17
CROSS STREET: Fire Road No. 1
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing x
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: 1982
Judith T. Te
Southold Town Clerk
DATE: June 10, 1987
(TOWN SEAL)
- 1
OFFICE OF THE TOWN CLERK ,c��FFO(,r "
Town of Southold �� C'QG Application No. 30
Judith T. Terry, Town Clerk -------
Town Hall, 53095 Main Road " '� '� :'� Residential
P. O. Box 1179 tofV;ifi Non-Residential
Southold, New York 11971 4
Telephone = j
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
WOW P' for
JUN 0 1 1981 OPERATION PERMIT
Town Clerk Southold SEPTIC TANK or CESSPOOL
Operation Permit No. z
/
Fee $
�
DATE j' 4
•
OWNER NAME: Cd60/4-u TE51-0-
//
OWNER MAILING ADDRESS: PD 60x
ft57 ///9-2/-6-/D
OWNER PROPERTY ADDRESS: q7' , #//37/J &
E '1 /AM- aw
OWNER TELEPHONE NUMBER: X77 / “;'
TAX MAP NO. : Section c32 / Block "/ Lot /7
CROSS STREET: , /2-6
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT:
LOCATION MAP: Must be attached hereto before permit may be issued.
.5E-E (Locate building and system; give north arrow and feet
of distance, approximately, to building and closest road.)
4
Signa u/ of Applicant
RECEIVED BY: e `—
RECEIVEDTown Cjrk's Of ice
DATE:
JUN 1019O7
Town Clerk Southold
N
Vi—j----- 6
, 11\ .
i S ,
c J• 4 G►
L
0
Geos
lit
'bis -Cr,-
<II'N,' Cc( ?
-.. ,( 1---10vSE &)
io
q
t
.2- Aill
Q J d
MAN 2 oAJ ac-tii 7