HomeMy WebLinkAboutP&G Clipper Holding „i agffetir
ELIZABETH A. NEVILLE 14° Town Hall, 53095 Main Road
TOWN CLERK ® ; P.O. Box 1179
�y Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ® �� Fax(631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER �--_ D ��®�1��, Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER _ 1�'�
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 11.020-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner P & C CLIPPER HOLDING CORP.
Mailing Address 1 PO BOX 932
Mailing Address 2
City St Zip CUTCHOUGE NY 11935-0000
Property Address 1 275 BOISSEAU AVENUE
Property Address 2
City St Zip CUTCHOGUE NY 11935-0000
Owner Telephone No. 631-734-7484
Tax Map No. section 62.00 block 1 lot 18.000
Cross Street HUMMEL AVENUE
Issue Date: 4/14/00 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK COW
TOWN OF SOUTHOLD &% •Wet-
• Application No. �0
LIZABETHA.NEVILLE,TOWN CLERK ,G $10.00 - Residential
P.O.BOX 1179 1
` $25.00 - Non-Residential
S-OUTHOLD,NEW YORK 11971 t'
Telephone �►�f
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
• Operation Permit No.
Fee $
DATE April 31. 2000
OWNER NAME: P & G Clipper Holding Corp.
OWNER MAILING ADDRESS: P.O Box 932
Cutchoque, New York 11935
OWNER PROPERTY ADDRESS: 275 Boisseau Avenue
Southold, New york 11971
OWNER TELEPHONE NUMBER: 631734-7484
TAX MAP NO. : Section 62.00 Block 1 Lot 18.000
CROSS STREET: Hummel Avenue
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing X
Residential Yes Non-Residential
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.)
Signature of Appiicant
RECEIVED BY: !L
Town Clerk's Office
DATE: / DC%
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