HomeMy WebLinkAboutCron OFFICE OF THE TOWN CLERK
Town of Southold � 4
Judith T. Terry, Town Clerk r lj
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Town Hall, 53095 Main Road '�E ;' r,•
P. 0. Box 1179 cma }*. '� '1. 144
Southold, New York 11971
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 307 Residential X
Fee $ 10.00 Non-Residential
Septic Cesspool X
NAME OF OWNER: Joan M. Cron
OWNER MAILING ADDRESS: P.O. Box 953
Cutchogue. New York 11915
OWNER PROPERTY ADDRESS: New Suffolk Avenue
New Suffolk, New York 11956
OWNER TELEPHONE NUMBER: 516-734-6998
TAX MAP NO. : Section 117 Block g Lot 11
CROSS STREET: Corner of Jackson Fifth an. Ne . . - . -
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing x
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: Unknown
Judith T. Ter
Southold Town Jerk
DATE: June 5, 1987
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(TOWN SEAL) 1
OFFICE OF THE TOWN CLERK .I�FFD
Town of Southold �� "� --7
C' Application No�� /
Judith T. Terry, Town Clerk � /
Town Hall 53095 Main Road ;-�" ~'x '� Residential �/
P. O. Box 1179 cr3 '; tri � Non-Residential
Southold, New York 11971 0' . 0_
Telephone1311‘
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ /0
DATE S/0
OWNER NAME: O /9- /1/ - C/ea
OWNER MAILING ADDRESS: e0 �7c ,9S3
C'Ge—7 e/fid ne 2 (I-
OWNER
OWNER PROPERTY ADDRESS: /j/_Qe/
7/2 s' 6
OWNER TELEPHONE NUMBER: 73(c _ 7
TAX MAP NO. : Section / 1 Block q Lot 7/
CROSS STREETR art c/Sa ' p/&%Gi NI-�z �J /2/ /c /9'-Q
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool a/ New Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: ®t/�
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.)
77-*/
':n.ture of Applicant
RECEIVED BY:
Town Ierk's fice
DATE:
r(7- sem
CESS('ooL.
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