HomeMy WebLinkAboutBasile OFFICE OF THE TOWN CLERK c�FFQ(f `," _
Town of Southold - � Olj
Judith T. Terry, Town Clerk - z L'
Town Hall, 53095 Main Road _:
P. O. Box 1179 • cs2 :--
Southold, New York 11971Q,= •'�
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Telephone j lard
(516) 765-1801 '
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
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Operation Permit No. 321 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool X
NAME OF OWNER: Joseph and Joan Basile
OWNER MAILING ADDRESS: 695 Westwood Lane, Box 592
Greenport, New York 11944
OWNER PROPERTY ADDRESS: 695 Westwood Lane
Greenport, New York
OWNER TELEPHONE NUMBER: 516-477-1220
TAX MAP NO. :- Section 33 Block 2 Lot 8
• CROSS STREET: Inlet Pond Road
•TYPE OF SYSTEM: Septic Tank New Existing
• Cesspool X New Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: .. April 17, 1987
•
.-ted100:
- - Judith T. Terry
Southold Town Clerk
DATES July 14, 1987
•
• (TOWN _SEAL)
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'OFFICE OF THE TOWN CLERK C3�FFU(/�•'=
Town of Southold �% , ��_ CQG' . Application Noc�o2/
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road c C 1 Residential
P. O. Box 1179 crs " _, z Non-Residential
Southold, New York 11971 O ��4 •`: •�`
Telephone 01 , •
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ /6
DATE aJ 11L/v� /P17.
OWNER NAME: 0-0 s ,E/771 0-3, / ,a%s/ <e
OWNER MAILING ADDRESS: ‘74' 7-1,7-"8 o p G4t7 ,8c�f/7
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OWNER PROPERTY ADDRESS: S /
OWNER TELEPHONE NUMBER: .r/Z•- /77:—/l�j/�3
oc 17/7TAX MAP NO. : Section 32 Block 'V Lot r
CROSS STREET: �✓5/4�7— A,r'O ) ii
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing p �
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT:
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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, Signature of App
or
RECEIVED BY:
Town Clerk's Office
DATE:
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Prepared BY
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C- L� i'� /— 0 _ --- '0 /z 7
—/~0 7Z/--�---------- ----- ----� Approved By
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