HomeMy WebLinkAboutNorth fork Bank (2) OFFICE OF THE TOWN CLERK • sc0FO[,rt-,"
Town of Southold max `, {
Judith T. Terry, Town Clerk 4.14-L-4
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Town Hall, 53095 Main Road Vi
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P. O. Box 1179 cn � .' '..^ ;
Southold, New York 11971 \` ‘r, '`
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Telephone 1,�
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(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation. Permit No. NR60 Residential
Non-Residential X
Fee $ 25.00
Septic Cesspool X
NAME OF OWNER: North Fork Bank & Trust Company
OWNER MAILING ADDRESS: 9025 Route 25, P.O. Box 1439
Mattituck, New York 11952
OWNER PROPERTY ADDRESS: Main Road
Southold, New York 11971 '
OWNER TELEPHONE NUMBER: 516-298-5000
TAX MAP NO. : Section 64 Block- 1 Lot 17 •
CROSS STREET: Maple Avenue
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing x
Residential Non-Residential X
DATE OF PREVIOUS PUMP-OUT: Unknown
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`Judith T. T ry
Southold Town Clerk
DATE: February 10, '1988
" -(TOWN SEAL)
•
OFFICE OF THE TOWN CLERK •�0Fai.��'-
Town of Southold &® �� . CSG•_ Application No. , ti
Judith T. Terry, Town 'Clerk . * `
Town Hall, 53095 Main Road �` : Residential
P. O. Box 1179 u''
�� � �, ` Non-Residential
Southold, New York 11971 ® ® �. r: •$
Telephone :®! 44 }1`a
(516) 765-1801
TOWN OF SOUTHOLD
•
JAN 2 p 1':7 SOUTHOLD WASTEWATER DISPOSAL DISTRICT
Tows MA Southold
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. fit) k 6,6
Fee $ 25.00
DATE January 6, 1987
OWNER NAME: North Fork Bank & Trust Company
OWNER MAILING ADDRESS: 9025 Route 25, P.O. Box 1439
Mattitnrk, NY 11957
OWNER PROPERTY ADDRESS: Main Road
Southold, NY 11971
OWNER TELEPHONE NUMBER: 516-298-5000
TAX MAP NO. : Section 64 Block 1 Lot 17.0
CROSS STREET: Maple Avenue
TYPE OF SYSTEM: Septic Tank X New Existing X
Cesspool X New Existing x
Residential Non-Residential x
DATE OF PREVIOUS PUMP-OUT:
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: �
own ler ' Office
DATE: