HomeMy WebLinkAboutMattituck Holding OFFICE OF THE TOWN CLERK • cl\ Fp(K`;"
Town of Southold -
Judith T. Terry, Town Clerk � r A
Town Hall, 53095 Main Road 8
5 yn 'mac
P. O. Box 1179 . : •�
Southold, New York 11971 Q - �- •�
Telephone Q( i
(516) 765-1801 •
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. NR 33 Residential
Fee $ 25.00 Non-Residential x
Septic Cesspool
NAME OF OWNER: Mattituck Holding Co. - Mattituck Inlet Marina & Shipyard Inn.
OWNER MAILING ADDRESS: Mill Road
Mattituck, New York 11952
OWNER PROPERTY ADDRESS: Mill Road
Mattituck. New York
OWNER TELEPHONE NUMBER: 516-298-4480
TAX MAP NO. : Section 106 Block 6 Lot 13.3
CROSS STREET: Naugles Drive
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool' X New • Existing x
Residential Non-Residential X
DATE OF PREVIOUS PUMP-OUT: October 30 1986
Judith T. Ter
Southold Town Clerk
DATE: January 16. 1987 11
(TOWN SEAL) I
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,OFFICE OF THE TOWN CLERK • S�FFOUrp- 22
Town of Southold CQ '% Application No.�� 3>
Judith T. Terry, Town Clerk �` <Y' •
fa:
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Town Hall, 53095 Main Road a • Residential
P. O. Box 1179 u' _ '` `` Non-Residential
Southold, New York 11971 *Be
Telephone 14*
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4/43 3
Fee $
DATE /- / 3 " 17
OWNER NAME: Si 4 T f i l/o 1111,1 u (17:0•• ikly -(0 q,
OWNER MAILING ADDRESS: i49 ILL ?eoP-.0 5ngtn`/G'2o Nc '
1'YI4--rrci , 1\l/
OWNER PROPERTY ADDRESS: 0.5 /keove_
OWNER TELEPHONE NUMBER: L '?$' VV SD
/ TAX MAP NO. : Section /VC Block Lot
,/ CROSS STREET: '
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing X
Residential Non-Residential
/ DATE OF PREVIOUS PUMP-OUT: (f),c • 3-t)-/ 1 I
✓ 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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AY/4c Y�.,,44e,e,�f
i Signature of Applicant {
RECEIVED BY: ,1— w Q e _.
ICcEO-Rign glerk's Office
DATE:_
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Town Clerk Southold
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