HomeMy WebLinkAboutNorth Fork Bank (2) ,
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JUDITH T. TERRY ` Town Hall, 53095 Main Road
TOWN CLERK v rrZ P.O. Box 1179
U." ,� Southold, New York 11971
REGISTRAR OF VITAL STATISTICS BYO` �� Fax (516) 765-1823
MARRIAGE OFFICERRECORDS MANAGEMENT OFFICER $�®.1' Fax
(516) 765 1801
FREEDOM OF INFORMATION OFFICER ,ir�
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 147-N Residential Non-Residential X
Fee $ 25.00 New Existing X
Name Of Owner NORTH FORK BANK
Mailing Address 1 C/O FACILITIES MGMT. DEPT.
Mailing Address 2 P. O. BOX 1439
City St Zip MATTITUCK NY 11952-0000
Property Address 1 54265 MAIN ROAD
Property Address 2
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 516-298-3240
Tax Map No. section 61 .00 block 2 lot 12.002
Cross Street YOUNGS AVENUE
Issue Date: 1/01/0 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK 'S�FFO(,� /-
Town of Southold O CQG' Application Nee /q7
Judith T. Terry, Towri Clerk ,` ` s_, $10.00 - Residential
Town Hall, 53095 Main Road ;
P. O. Box 1179 crs ' 1r ; $25.00 - Non-Residential x
Southold, New York 11971 O
Telephone 01 *6- '�•
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
•
DATE 5/20/94
OWNER NAME: North Fork Bank (c/o Facilities Mgmt. Dept. )
OWNER MAILING ADDRESS: P. O. Box 1439
Mattituck, NY 11952
OWNER PROPERTY ADDRESS: 54265 Main Road
Southold, NY 11971
, OWNER TELEPHONE NUMBER: 298-3240
TAX MAP NO. : Section 61 Block 2 Lot 12.2
CROSS STREET: Youngs Avenue
TYPE OF SYSTEM: Septic Tank x New Existing x
Cesspool New Existing
Residential Non-Residential x
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 Applicant
.' RECEIVED BY:
Town Clerk's Office
DATE: