HomeMy WebLinkAboutAksten OFFICE OF THE TOWN CLERK F�
Town of Southold
Judith T. Terry, Town Clerk 1‘%
Town Hall 53095 Main Road k
P. 0. Box 1179 y .93 4 y�
Southold, New York 11971 - Q • • ;,•�"�,:~Q�
Telephone VO/ ON
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL -
Operation Permit No. 422 Residential X
Fee $ 10.00
- Non-Residential
Septic Cesspool X
NAME OF OWNER: Alec V. Aksten
OWNER MAILING ADDRESS: P.O. Box 482
Southold, New York 11971
OWNER PROPERTY ADDRESS: Oak Drive, Reydon Shores
• Southold, New York
OWNER TELEPHONE NUMBER: 516-765-2590
TAX MAP NO. : Section 80 Block 1 Lot 42
CROSS STREET: Shore Drive
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New - Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: October 1975
•
1rlitl-. T Tnrrv`
Southold Town Clerk
DATE: September 16, 1987
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TOWN SEAL)
•
OFFICE OF THE TOWN CLERK c0FOCA- -
Town of Southold �� CQG Application N.
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road '4 :< I Residential
P. O. Box 1179 u' •.� ' Non-Residential
Southold, New York 11971 O c® 4� �`
Telephone _ •
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE j6,.//92?
OWNER NAME:
OWNER MAILING ADDRESS: p.0t9i L/?-
OWNER PROPERTY ADDRESS: -0 :Li7� �' -p-'45T
m rd) 149)/-
OWNER TELEPHONE NUMBER: 2C 5,-, S5 O
TAX MAP NO. : Section ?'t5 Block / Lot l
CROSS STREET: /j l
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing X
Residential Non-Residential
- -DATE OF PREVIOUS PUMP-OUT: l9cs�� 75"
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.)
(2,16c./ Pp
Signature of Applicant
g
RECEIVED BY�� � _
Town erk's Of i e
DATE: 9 - /i - �7
J.COOPER
Notary I• 01.4011"="'..1`' York
N —"Poi Suffolk County
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