HomeMy WebLinkAboutAkeson OFFICE OF THE TOWN CLERK • 'OF O(x`,i'
Town of Southold
Judith T. Terry, Town Clerk
Town Hall, 5305 Main Road ~ .
P. 0. Box 1179 cr3 •
Southold, New York 11971 �0� /
Telephone ®1
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 146 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool X
NAME OF OWNER: Kenneth W. Akeson
OWNER MAILING ADDRESS: 168 Kilburn Road
Garden Oty, New York 11530
OWNER PROPERTY ADDRESS: Cottage #1 , Kimogenor Point (80 Jackson Street)
New Suffolk, New York 11956
OWNER TELEPHONE NUMBER: _74612273
TAX MAP NO. : Section 117 Block 10 Lot 1
CROSS STREET: New Suffolk Avenue
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: Unknown
Judith T. Terry _-
Southold
Southold Town Clerk
DATE: November 13, 1986
(TOWN SEAL) -
•
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OFFICE OF THE TOWN CLERK �FFOur
�
Town of Southold \C>'. A �� ' Application No. lz/6
Judith T. Terry, Town Clerk
"14 .•G Residential
Town Hall, 53095 Main Road „ f
P. O. Box 1179
1723 -_ r �' Non-Residential
Southold, New York 11971 0
Telephone = 1
(516) 765-1801
TOWN OF SOUTHOLD
IR ECEVED
_ SOUTHOLD WASTEWATER DISPOSAL DISTRICT
0 01 01 1986
Town Clerk Southold APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. /'-G
Fee $ 10.00
DATE September 25, 1986
OWNER NAME: KENNETH W. AKESON
OWNER MAILING ADDRESS: 168 KILBURN ROAD
GARDEN CITY, NEW YORK 11530
OWNER PROPERTY ADDRESS: COTTAGE 4/1, KIMOGENOR POINT(Rf Jackson St. ) -
NEW SUFFOLK, NEW YORK 11956
OWNER TELEPHONE NUMBER: 746-2273
TAX MAP NO. : Section 117 Block 10 Lot 1 #1
CROSS STREET: ,PA: SG//7=o L7c- ,j vG,
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential X Non-Residential VZ-ST
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DATE OF PREVIOUS PUMP-OUT: t� oc,9s� - I(LSt5(ai�e c,91.)
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 If—Applicants
RECEIVED BY: �-
Town clerk�e
RECEIVED
DATE:
®V13 IN
Town Clerk Southold ,
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