HomeMy WebLinkAboutNorth Fork Beach Condo OFFICE OF THE TOWN CLERK ' i �FFOC/((
Town of Southold �..=_ �4,
Judith T. Terry, Town Clerk %%
Town Hall, 53095 Main Road
P. O. Box 1179 ;;v' f �
Southold, New York 11971
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. NR 31 Residential
Non-Residential X
Fee $ 25.00
Septic X Cesspool X
NAME OF OWNER: North Fork Beach Condominiums
c/o Thule
OWNER MAILING ADDRESS: 50 No. New York Avenue
Huntington, New York 11743
OWNER PROPERTY ADDRESS: North Road (Route 48) •
Southold, New York
OWNER TELEPHONE NUMBER: 516-427-9500
TAX MAP NO. : Section 135 Block 2 Lot 23
CROSS STREET: Soundview Avenue
TYPE OF SYSTEM: Septic Tank X New Existing x
Cesspool X New Existing x
Residential Non-Residential x
DATE OF PREVIOUS PUMP-OUT: October 17, 1986
Judith T. Terr
Southold Town Clerk
DATE: December 22, 1986
(TOWN SEAL)
4/6
OFFICE OF THE TOWN CLERK c�V�FO(,rCQ
�'- �/
Town of Southold �� Application No./(//e(3}
l)
Judith T. Terry, Town Clerk . '' �'' '
� -•C 7 Residential
Town Hall, 53095 Main Road ax r'
�J to ;
P. O. Box 1179 ,� ' �': '��;' Non-Residential
Southold, New York 11971 O#4962-'.4(..
`"` •
Telephone _ 1 F 0 '°
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. A7R 3
Fee $ „?5".0.°
DATE
OWNER NAME: IVOrr6. Fork. 6..e.4--(4_ clog*/Wuvlrt S
OWNER MAILING ADDRESS: S-0 N o . A)w L(o -IJ-e.-
OWNER PROPERTY ADDRESS: 4' iri-4 ed, $
�5�� N/ 1/ , 7/
J �(�
OWNER TELEPHONE NUMBER: Va 7—J,s-o o
TAX MAP NO. : Section /3.5- Block a Lot
CROSS STREET: (01,1 it)d VI eAw U -e
TYPE OF SYSTEM: Septic Tank J New Existing
Cesspool J New Existing ✓
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: OCQ. ti I�g
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 PA-(ctljf
RECEIVED BY: (le.. cLU
Town CI/rk's Offfe
DATE: HMSO
DEQ 191986
Town Clerk Southold C I (- �L1 —9SD c7
() d's-iR (s-1 E