Loading...
HomeMy WebLinkAboutAnnabel OFFICE OF THE TOWN CLERK • L��' U[/(`,' Town of Southold , � Judith T. Terry, Town Clerk Z Town Hall, 53095 Main Road P. O. Box 1179 a y' Southold, New York 11971 p ® _ 0� •• Telephone :'0,( N° • (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 149 Residential X Non-Residential Fee $ 100.00 Septic Cesspool x NAME OF OWNER: Raymond Annabel OWNER MAILING ADDRESS: 34 HIIlcrest Avenue Port Jefferson. New York 11777 OWNER PROPERTY ADDRESS: 4550 Stillwater Avenue Cutchogue, New York OWNER TELEPHONE NUMBER: 473-6289 TAX MAP NO. : Section 137 Block 2 Lot 7 CROSS STREET: Track Avenue TYPE OF SYSTEM: Septic Tank X New Existing x Cesspool X New Existing x Residential X Non-Residential DATE OF PREVIOUS PUMP-OUT: Sept. 1986 400 • 4148;?.....4 Judith T. Terr Southold Town Clerk DATE: November 17, 1986 (TOWN SEAL) OFFICE OF THE TOWN CLERK •c.„t9 Ji''�. Town of Southold CQG' Application No./`'? Judith T. Terry, Town Clerk . # 4-.91V Mkt V.41‘1 .- Residential Town Hall, 53095 Main Road � a�� , t�: P. O. Box 1179 cn t` !: Non-Residential Southold, New --York 11971 K �� ��� Telephone (516) 765-1801 Ol TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Hy Fee $/® ©� DATE #/-06 06 OWNER NAME: J? rjYôjp j►I/1/%4,� OWNER MAILING ADDRESS: £ 12.E—S' /' v Po R.1 -i—1 {rSv.vc, J4 ). // 7 7 OWNER PROPERTY ADDRESS: 4$5-0 £'T1 G vr.4 j v OWNER TELEPHONE NUMBER: 47,S - 2_6 9 TAX MAP NO. : Section /37 Block Lot 7 CROSS STREET: A/Oil4 ! V TYPE OF SYSTEM: Septic Tank New Existing Cesspool, New Existing Residential V on-Residential DATE OF PREVIOUS PUMP-OUT: c 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.) a .nature .f Applicant RECEIVED BY: �EC���erk's ffice� DATE: NOV 17 1ow Clerk Southold - w 45:60 � T► wAiM I/1_ O� ooL. s c s5 o EPT/C 7-441K 7 phr'o GfPw HouE STILL wATEg ,qv