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Home My WebLink AboutTaylor A yam► ; JUDITH T. TERRY ` : Town Hall, 53095 Main Road TOWN CLERK v "ac P.O. Box 1179 REGISTRAR OF VITAL STATISTICS �` - Southold, New York 11971 MARRIAGE OFFICER Q OV' ��, Fax (516) 765-1823 411 %w .' 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. 3022-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New Existing X Name Of Owner TAYLOR, THOMAS R. Mailing Address 1 3350 PINE NECK ROAD Mailing Address 2 City St Zip SOUTHOLD NY 11971-0000 Property Address 1 3350 PINE NECK ROAD Property Address 2 City St Zip SOUTHOLD NY 11971-0000 Owner Telephone No. 516-765-1038 Tax Map No. section 70.00 block 12 lot 2.000 Cross Street PARK WAY Date Of Last Pump Out 0/00/93 Issue Date: 5/14/93 Judith T. Terry Southold Town Clerk (TOWN SEAL) OFFICE OF THE TOWN CLERK SAF FO(,(r - 3d Town of Southold -Q CD Application N. Judith T. Terry, Town Clerk . � �► Town Hall, 53095 Main Road t `, ',.4; -'� $10.00 - Residential ) Lin pax P. O. Box 1179 cn :' z $25.00 - Non-Residential Southold, New York 1197142,� �, _ � - ' ,( C-•••, Telephone -7.°1 ` (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ 1 622- • DATE tv\14\1 6, , /593 OWNER NAME: I A'y IDR OWNER MAILING ADDRESS: \f I i t 7 / OWNER PROPERTY ADDRESS: �titi� l • OWNER TELEPHONE NUMBER: 760.5 — /D38 TAX MAP NO. : Section 70 Block / Lot CROSS STREET: TYPE OF SYSTEM: Septic-Tank New Existing Cesspool ) New Existing Residential Non-Residential DATE OF PREVIOUS PUMP-OUT: iThq-Itci 155 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.) 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