HomeMy WebLinkAboutBiggs (2) '" `�`� s ' Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
JUDITH T.TERRY � 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. 968-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner B I GGS, SOPH I E
Mailing Address 1 470 MARLENE LANE
Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
Property Address 1 470 MARLENE LANE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-4088
Tax Map No. section 143.00 block 2 lot 23.000
Cross Street MAIN ROAD
Date Of Last Pump Out 0/00/00
Issue Date: 12/22/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK of
OFFICE �y/
Town of Southold � .'--Mire;
Application No. /w
Judith T. Terry, Town Clerk �.�,. � s
Town Hall, 53095 Main Road . wCc. Residential L�
P. O. Box 1179
y= ;' Non-Residential
Southold, New York 11971 O -w O� /
Telephone - - -- �( 0 '°
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL -DISTRICT
APPLICATION
RECEIVER
for
DEC 2 ® 1988 OPERATION PERMIT
o(e 5o ®TI SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ • •
DATE-W.9-e, nt
OWNER NAME: -E'd t#/ B J g-3
OWNER MAILING ADDRESS: Al .Q ,'
OWNER PROPERTY ADDRESS: ,,
OWNER TELEPHONE NUMBER: cm,/
TAX MAP NO. : Section /43 Block Lot
CROSS STREET: .--------
TYPE
. ------TYPE OF SYSTEM: Septic Tank New Existing
Cesspool / New Existing X'
Residential( Non-Residential
DATE OF PREVIOUS PUMP-OUT: Tt _-
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.)
'gnature of A plicant
RECEIVED BY: c�-O_ X10 '
E Q ®jTTowtn CI rk's Office
DATE:
DEC 22 1988
so+gt nld Town Clerk
I
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