HomeMy WebLinkAboutAbelson OFFICE OF THE TOWN CLERK • .c0FQ[x`,'
Town of Southold Zs
Judith
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Judith T. Terry, Town Clerk ` L�
Town Hall, 53095 -Main Road
P. O. Box 1179 `
Southold, New York 11971 Q
Telephone "'Ojt
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 117 Residential X
Non-Residential
Fee $ 10.00
Septic x Cesspool
NAME OF OWNER: Nathaniel 0. Abelson
OWNER MAILING ADDRESS: 54 East 91st Street
New York, New York 10128
OWNER PROPERTY ADDRESS: 2545 '9rrowhead:Lane
Peconic, New York
OWNER TELEPHONE NUMBER: 212-722-7534 or 516-734-6437
TAX MAP NO. : Section 98 Block 3 Lot x
CROSS STREET: Indian Neck Lane
TYPE OF SYSTEM: Septic Tank X New Existing x
Cesspool New Existing
Residential x Non-Residential
DATE OF PREVIOUS PUMP-OUT: Unknown
Judith T. Ter ,a
Southold Town Clerk
DATE: October 31, 1986
(TOWN SEAL) -
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OFFICE OF THE TOWN CLERK i5F0(,rC'-
Town of Southold � QG' , Application No. //7'
Judith T. Terry, Town Clerk ix. y
Town Hall 53095 Main Road {' 7 Residential
P. O. Box 1179 cr3 ' Non-Residential
Southold, New York 11971 �
Telephone _01 Y► '�
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OCT 311'•;',
APPLICATION
TOM Cterk geld
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. /j7
Fee $ /D
DATE 22 October, 1986
OWNER NAME: Nathaniel O. Abelson
OWNER MAILING ADDRESS: 54 East 91st Street, New York, NY 10128
OR 2545 Arrowhead Lane, Peconic, NY 11958
OWNER PROPERTY ADDRESS: Corner, Indian Neck and Arrowhead Lanes,
Peconic, NY 11958
OWNER TELEPHONE NUMBER: (212) 722-7534 OR (516) 734-6437
TAX MAP NO. : Section 98 Block 3 Lot 1
CROSS STREET: Indian Neck and Arrowhead Lanes
TYPE OF SYSTEM: Septic Tank X New Existing X
Cesspool New Existing
Residential X 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.)
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Signature of Applicant
RECEIVED BY:(
Towr/Clerk's Office
DATE: ei-oJ/,, 5-A
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