HomeMy WebLinkAboutP&M Devel '1,�.10lcOf OUree;may=
JUDITH T. TERRY •
; Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS 1 Southold, New York 11971 •
MARRIAGE OFFICER Q ®� Fax Fax (516) 765-1823
'Woe 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. 2060-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New X Existing
Name Of Owner P & M DEVELOPMENT OF NEW YORK
Mailing Address 1 P. O. BOX 300
Mailing Address 2
City St Zip MASTIC BEACH NY 11951-0000
Property Address 1 515 HORSESHORE DRIVE
Property Address 2
City St Zip CUTCHOGUE NY 11935-0000
Owner Telephone No. 516-395-1748
Tax Map No. section 95.00 block 4 lot 18.027
Cross Street ROUTE 48
Date Of Last Pump Out 0/00/00
Issue Date: 3/01/93 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
'II I
OFFICE OF THE TOWN CLERK 0S.FFO(,( 0C,e)
Town of Southold Q CQ ' Application No.
� F
Judith T. Terry, Town Clerk • � �
�;��, � .•G%1 $10.00 - Residential
Town Hall, 53095 Main Road =
P. O. Box 1179 LT,
_ `'' '4►�•` $25.00 - Non-Residential
Southold, New York 11971
Telephone .( •
y►
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 14 1
Fee $ •
DATE
OWNER NAME: 7e M beiVeippaten-f OP Nem )/®(A. Tix'•
OWNER MAILING ADDRESS: PO , BOX 300
Mos-fie, Be Ldj; k'wi /orL lC 90"1
OWNER PROPERTY ADDRESS: 6-/,ice i-/ar seshoc :brim
CviChtoGLle, ive1u YQ�1( 11135-
OWNER TELEPHONE NUMBER: C/0 395- /7eJ
TAX MAP NO. : Section 6/5', ®® Block 7 Lot /us O '7
CROSS STREET: RoOrrE J46
TYPE' Of SYSTEM: Septic Tank New Existing
Cesspool New 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.)
R OfV,
Signature of A plicant
RECEIVED -BY: - -
Town Clerk's Office
DATE:
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SSoI � Uosuthat5red alteration or addlwo
tp this aurvsy is a violation of
FF o� &orlon 7209 0! Bass Naw York Stats
Ei-EV=56.So cl< Education /\
q•eFt. STEPS Copies of this Survey Map not bearing U
c_ -✓c 53 o the land surveyor's inked seal or
embossed seal shall not be considered
65 63' to be a valid true copy. (�
Guarantees indicated hereon shell run `
' only to the person for whom the survey
is prepared sad on his behalf to the
latae Cosapaaf, Govarmmtal Agency
and to the Msi&ness of It et Lendlnp -
WELL. Institution. Guarantees are not trans• N
terabit to additional Institutions or
subsequent owners.
Theoffsets from property line• (Met
lateen are not intended to guide In ti -
n owalla" Qii
pools, f
fding fences, or aril otlfill
• L.O.T ` v!^d esnstrection. I t/ U
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