HomeMy WebLinkAboutTin Hung Town Hall, 53095 Main Road
vr'® i P.O. Box 1179
l'+'. �s Southold, New York 11971
JUDITH T.TERRY . l���'' TELEPHONE
TOWN CLERK (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 64-N Residential Non-Residential X
Fee $ 25. 00 Septic Cesspool X
New Existing X
Name Of Owner TIN HUNG RESTAURANT
Mailing Address 1 31315 MAIN ROAD
Mailing Address 2
City St Zip CUTCHOGUE NY 11935-0000
Property Address 1 31315 MAIN ROAD
Property Address 2
City St Zip CUTCHOGUE NY 11935-0000
Owner Telephone No. 516-734-7062
Tax Map No. section 97. 00 block 5 lot 12 . 000 ,
Cross Street COX LANE
Date Of Last Pump Out 0/00/00
/V
Issue Date: 3/16/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK COW C," ,, // �e
Town of Southold Application No.N� (2"�
Judith T. Terry, Town Clerk ,� , **A.'
Town Hall, 53095 Main Road ` Y ` Residential
P. O. Box 1179x h,i Non-Residential
Southold, New York 11971 O` ®r "` 0���`
Telephone 0.( N '°•
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
•
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ �� . 0 O
DATE (7f04-1
OWNER NAME: 7I ` hJ ( C,
OWNER MAILING ADDRESS: Sr5
CidrcAl OcA mss , y.
OWNER PROPERTY ADDRESS: S4-- ( 11.- ( u
1,o 6. 50016Se t4,AN -S1 I
OWNER TELEPHONE NUMBER: (I 2 -/.2) . —10
1 -
TAX MAP NO. : Section q l Block tj Lot i
CROSS STREET-: t✓O)k,
TYPE OF SYSTEM:' , Septic Tank/ New Existing
Cesspool New 10 Existing
Residential Non-Residential ✓,
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: .
Town Clerk's Office
DATE: - - -
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