HomeMy WebLinkAboutSouthold Park Dist (2) r+ ef�lS�
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JUDITH T. TERRY
Town Hall, 53095 Main Road
TOWN CLERK ® y P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER vFax (516) 765-1823
NA Ls:13 000-J
! Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 131-N Residential Non-Residential X
Fee $ 25.00 Septic Cesspool X
New Existing X
Name Of Owner SOUTHOLD PARK DISTRICT
Mailing Address 1 P. O. BOX 959
Mailing Address 2
City St Zip SOUTHOLD NY 11971-0000
Property Address 1 HORTON'S POINT LIGHTHOUSE
Property Address 2 LIGHTHOUSE ROAD
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 516-765-1659
Tax Map No. section 50.00 block 1 lot 11 .000
Cross Street SOUNDVIEW AVENUE
Date Of Last Pump Out 0/00/00
Issue Date: 7/20/92 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFF)CEpOF THE TOWN CLERK coFOur '`
Town of Southold � = Application No. f
Judith T. Terry, Town"Clerk' t;t' . y
Town Hall, 53095 Main Road z . a.,.: $10.00 - Residential
p. 0. Box 1179 tri xx s�,?; +'' �
•�.� $25.00 - Non-Residential
Southold, New York 11971
Telephone *Q( I y#;1'
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
• - OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.N k i /
Fee $
DATE July 14, 1992
'OWNER NAME: Southold Parr District •
OWNER MAILING ADDRESS: p.o. Box 959
•
Southold, Ny 11971
OWNER PROPERTY ADDRESS: Norton's Point Lighthouse
Lighthouse Rd , Southold, NY
OWNER TELEPHONE NUMBER: 765 1659
TAX MAP NO. : Section50 Block 1 Lot 11
CROSS STREET: f=Lie,„e4sc' .c �P
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool x New Existing x
Residential Non-Residential x
• DATE OF PREVIOUS PUMP-OUT: 5/92
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.)
.}d ee-Cf--e_ /46e-et, -
Signature of Applicant
RECEIVED BY: AL -
Town Clerk'sb-ffice
DATE: /o'�OA�