HomeMy WebLinkAboutAshton _ _,
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N Town Hall, 53095 Main Road
P.O. Box 1179
=- ® �� Southold, New York 11971
JUDITH T.TERRY " i,/�i4��� FAX(516)765-1823
TOWN CLERK TELEPHONE(516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 1236-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner ASHTON, MARGARET
Mailing Address 1 P. O. BOX 457
Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
Property Address 1 795 LOVE LANE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-9498
Tax Map No. section 141 .00 block 3 lot 27.000
Cross Street ROUTE 48
Date Of Last Pump Out 0/00/86
Issue Date: 8/29/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK ��FD s
Town of Southold
�� �CQG Application No.
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road H .L $10.00 - Residential
p. 0. Box 1179 ca3 � r • $25.00 - Non-Residential
Southold, New York 11971 OCZNs,
Telephone j.( o0
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
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APPLICATION
Nrci
for
AUG 21 MN
OPERATION PERMIT
WO MA
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ 1(?• 6 d
DATE �j� /f � 9
OWNER NAME: k6I4 ( E I P" • F SHToN •
OWNER MAILING ADDRESS: / D , 'Sox Y57
`1 5 / b U E LA /4.1 e � lel A. 7Z-l T O CL
OWNER PROPERTY ADDRESS: 644 W1-6
OWNER TELEPHONE NUMBER: q g 93
TAX MAP NO. : Section /tf Block J Lot �7
CROSS STREET: RI. Tg
TYPE OF SYSTEM: Septic Tank 'I New Existing
Cesspool V New Existing
Residential 1 Non-Residential
DATE OF PREVIOUS PUMP-OUT: �M,
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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rik160) t14 d # a . ��
Signat a of Applicant
RECEIVED BY: C�
�, ,.. 1Clerk' ' Office
DATE: AUG 291se
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Town Hall, 53095 Main Road
O �i`� P.O. Box 1179
__ ®�, ®�sI Southold, New York 11971
JUDITH T.TERRY = � r0'0.ED, I FAX(516)765-1823
TOWN CLERK TELEPHONE(516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
August 21, 1989
Margaret A. Ashton
P. O. Box 457
795 Love Lane
Mattituck, New York 11952
Dear Ms. Ashton:
I am returning your application for a Cesspool or Septic Tank Operation
Permit. Additional information is required before your application may
be processed.
Please complete the item (s) highlighted on your application.
Location Map - May be a copy of your survey with the location
of the cesspools indicated or a sketch of your
property showing the location of the buildings,
cesspool system, approximate distance in feet
to buildings and closest road, and an arrow
indicating north.
After you have completed the requested information, please return
the application, location map, and your check, which is enclosed herewith.
Thank you for your cooperation.
Very truly yours,
Judith T. Terry
Southold Town Clerk
Enclosure
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