HomeMy WebLinkAboutAbbott OFFICE OF THE TOWN CLERK44
own of Southold
Judith TT. Terry, Town Clerk _ -A4
Town Hall, 53095 Main Road ti
P. O. Box 1179
Southold, New York 11971 Q •
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Telephone ,V" t
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 100 Residential xx
Non-Residential
Fee $ 10.00
Septic Cesspool XX
NAME OF OWNER: I James Abbott •
OWNER MAILING ADDRESS: 58 Hathaway Drive
Garden City, New York 11530
OWNER PROPERTY ADDRESS: Peconic Bay Blvd.
Laurel, New York
OWNER TELEPHONE NUMBER: 328-9135
TAX MAP NO. : Section 126 Block 5 Lot 3
CROSS STREET: * mile east of Bray Avenue
• TYPE OF SYSTEM: Septic Tank New Existing
Cesspool XX New Existing xx
Residential XX Non-Residential
DATE OF PREVIOUS PUMP-OUT: July 1986
•
•
Judith T. Terr
Southold Town Clerk
DATE: October 20, 1986
r (TOWN SEAL)
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OFFICE OF THE TOWN CLEgKFFpLA'
Town of Southold �� : ... COG' Application No/O�
Judith T. Terry, Town Clerky �'�
� Residential
Town Hall, 53095 Main Road p = .
P. O. Box 1179
cn �. Non-Residential
� ��,
Southold, New York 11971
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
RECEIVED
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OCT 20 1986
Trnnm C!erk Southold APPLICATION
I L,.
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. /9
Fee $ /•c0
DATE z.,6
OWNER NAME: diy-m&,5 /9 13/b c
OWNER MAILING ADDRESS: 3-8" 1, ri/ f41 d)2cUG-
/92O6A) C ( 7 Y ( ( s 3
OWNER PROPERTY ADDRESS: PL c N. C �� y 11,0
l!� Ls (-
OWNER TELEPHONE NUMBER: 3c5 / 35
TAX MAP NO. : Section Block Lot
CROSS STREET:,)_a.e.,„2„..„, t3 i ( `E- 366- / /1- E4,67 (3/?, y
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: k cS'A'
LOCATION MAP: Must be attached hereto before permit may be issued.
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(3 ___ (Locate building and system; give north arrow and feet
of distance, approximately, to building and closest road.)
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Signature of Applicant
RECEIVED BY: c a--fl"l -
Town erk's Office
DATE: