HomeMy WebLinkAboutLong Island Vineyards OFFICE OF THE TOWN CLERK `-4 Four
Town of Southold � OG
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road a3�*
P. O. Box 1179 _' � w� �:
Southold, New York 11971 \ p " ` •'
Telephone 40l
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. NR 28 Residential
Non-Residential x
Fee $ 25.00
Septic X Cesspool X
NAME OF OWNER: Long Island Vineyards Inc.
OWNER MAILING ADDRESS: P.O. Box 927
Cutchogue, New York 11935
OWNER PROPERTY ADDRESS: Private Road off Alvahs Lane
Cutchogue, New York
OWNER TELEPHONE NUMBER: 516-734-5158
TAX MAP NO. : Section 102 Block 1 Lot 3.3
CROSS STREET: County Road 48
TYPE OF SYSTEM: Septic Tank X New Existing x
Cesspool X New Existing X
Residential Non-Residential X
DATE OF PREVIOUS PUMP-OUT: Unknown
Judith T. Terry
Southold Town Clerk
DATE: December 5, 1986
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OFFICE OF THE TOWN CLERK
Town of Southold Application No.
Judith T. Terry, Town Clerk
.' ^~ .•G I Residential
Town Hall, 53095 Main Road c
P. O. Box 1179 cry • "4, Non-Residential
Southold, New York 11971 O ` � •�`
Telephone .(
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
- -Tor— -- -OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.A.Ze�
Fee $
DATE - /4 5/6
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OWNER NAME: G� L2,-i,f1 •
OWNER MAILING ADDRESS: /3 X q27
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OWNER PROPERTY ADDRESS: 616 / .`S
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OWNER TELEPHONE NUMBER: 5-76 7 7 5-/ rf
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TAX MAP NO. : Section Block Lot
CROSS STREET: 5.'&(A^ '2 Se
TYPE OF SYSTEM: Septic Tank New Existing v
Cesspool New Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: -
LOCATION MAP: Must be attached hereto before permit may be issued. c_e, vg
(Locate building and system; give north arrow and feet
of distance, approximately, to building and closest road.)
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Signature of Applicant
RECEIVED
Town Clerk's
DATE: ( EWE®
DEP ®5 10%
Town Clerk Southold
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