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Home My WebLink AboutAlbertson (2) OFFICE OF THE TOWN CLERK �," Town of Southold " : Judith T. Terry, Town Clerk Z Town Hall, 53095 Main Road P. O. Box 1179 t." • y �� Southold, New York 11971 O Telephone �l jt (516) 765-1801 — ' TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT OPERATION PERMIT SEPTIC TANK or CESSPOOL • Operation Permit No. 170 Residential X Fee $ 10.00 Non-Residential Septic x Cesspool x NAME OF OWNER: Robert T. Albertson OWNER MAILING ADDRESS: 2330 Brigantine Drive Southold. New York 11971 OWNER PROPERTY ADDRESS: 2330 Brigantine Drive • Southold, New York OWNER TELEPHONE NUMBER: 516-765-1012 TAX MAP NO. : Section 79 Block q Lot 20 CROSS STREET: North Bayview Road TYPE OF SYSTEM: Septic Tank X New Existing x Cesspool X New Existing x Residential X Non-Residential DATE OF PREVIOUS PUMP-OUT: None loge-he:04 Judith T. Terre Southold Town Clerk DATE: December 8, 1986 I (TOWN SEAL) • II OFFYCE OF THE TOWN CLERK , � �jv�FfJIL Town of Southold Application No.CG / V Kt ,, Judith T. Terry, Town Clerk �` rte, y • Town Hall, 53095 Main Road 7 Residential �_ P. O. Box 1179 un .k;1-; `�`�.�� ;' Non-Residential Southold, New York 11971 O�% 0��` Telephone .( ire ', (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. /70 Fee $10. 0'0 DATE December 4, 1986 OWNER NAME: Robert T. Albertson OWNER MAILING ADDRESS: 2330 Brigantine Drive Southold, New York 11971 OWNER PROPERTY ADDRESS: 2330 Brigantine Drive Sonthnl c , NPw York 11971 OWNER TELEPHONE NUMBER: 765-1012 TAX MAP NO. : Section 79 Block 4 Lot 20 CROSS STREET: North Bayview Road TYPE OF SYSTEM: Septic Tank X New Existing x Cesspool New Existing Residential X Non-Residential • DATE OF PREVIOUS PUMP-OUT: NONE 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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