HomeMy WebLinkAboutHalf Hollow Nursery Realty skIt1
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��� Mi Town Hall, 53095 Main Road
�1Nom® O ��; P.O. Box 1179
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`� Southold,New York 11971
JUDITH T.TERRY TELEPHONE
TOWN CLERK (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. 3589-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner HALF HOLLOW NURSERY REALTY
Mailing Address 1 595 HALF HOLLOW ROAD
Mailing Address 2
City St Zip DIX HILLS NY 11746-0000
Property Address 1 3100 MAIN ROAD
Property Address 2
City St Zip LAUREL NY 11948-0000
Owner Telephone No. 516-667-11400
Tax Map No. section 125.00 block 3 lot 7.002
Cross Street LAUREL LANE
Issue Date: 2/18/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK c.0FGU(
Town of Southold �% Application No.3 �9
Judith T. Terry, Town Clerk �� ''. . i,{r �' ;
^..: $10.00 - Residential
Town Hall, 53095 Main Road ` ` " ! ';
P. O. Box 1179 w F,.,•;.. Y `: "M 1,i $25.00 - Non-Residential
Southold, New York 11971 O �c
Telephone - $`N4 . ..
(516) 765-1801
TOWN OF SOUTHOLD -
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLI CAT ION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ AO •c?-0
44,1,- , DATE o /Z 9 9
�q /-r �YO//a LU l 1 d , '1.1.70-;°l M Are/S 7bUC.
OWNER NAME:
OWNER MAILING ADDRESS: ,...6 -R�1,��� +�
S9S" - 1 'i MpgrPdf D 66 -a?Cis N` , (f. //7c/6
OWNER PROPERTY ADDRESS : l0 0 / //u IC-Ot
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OWNER TELEPHONE NUMBER: cc/6 G 64 - M0
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TAX MAP NO. : Section B ocHai/Cal
kLot
A u__ri t CROSS STREET: �Ctik re ( ICT.I U__ 9l- CP+ 2
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential X 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.)
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411
4411Ildra ___
lb na71Trik Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
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