HomeMy WebLinkAboutLil Max Ltd tooecc3'!f DUre.
ra �X * Town Hall, 53095 Main Road
��� P.O. Box 1179
___ � s� �t ��' Southold, New York 11971
JUDITH T.TERRY '= � yrs ���" 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. 94-N Residential Non-Residential X
Fee $ 25.00 Septic Cesspool X
New Existing X
Name Of Owner LIL MAX LTD.
Mailing Address 1 BONNIES BY THE BAY
Mailing Address 2 725 FIRST STREET
City St Zip NEW SUFFOLK NY 11956-0000
Property Address 1 725 FIRST STREET
Property Address 2
City St Zip NEW SUFFOLK NY 11956-0000
Owner Telephone No. 516-734-6664
Tax Map No. section 117.00 block 8 lot 15.000
Cross Street MAIN STREET
Date Of Last Pump Out 0/00/00
Issue Date: 8/25/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE 'TOWN, CLERK ���FFQ +'- //
Town of outhold . ® .,44,-„;,-,., _ �� Application No./k.) l�' 9`�
Judith T. Terry •Town Clerk �` Z t' & i►
Town Hall, 530 Main Road a - :4. ) Residential
P. O. Box 1179 �'#: tio�'; ' .' Non-Residential
Southold, New York 11971 Oi®, 0� �$
Telephone _"0.(y '�� , '6
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Oper.,.:.;' Permit No
Fee $
DATE ��/
OWNER NAME: LCL 774 /51)1" L
OWNER MAILING ADDRESS: 1/43 ,/Q J
1 G(2 --<;/97- -4. . /G)`((//77
OWNER PROPERTY ADDRESS:
j-7/9"- -----
OWNER TELEPHONE NUMBER: , S'—/- 7 2 6.- -6-
j • TAX MAP NO. : Section BlockLot
CROSS STREET: /r-/-1/41/-/Y .S / — '
•
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New xisting
• Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: _,5—,27—
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.) -
Sig atur1 of Applic•, t
RECEIVED BY: -
Town Clerk's Office
DATE:
d
,