HomeMy WebLinkAboutThe Cove at Southold JUDITH T.TERRY � � � r �d• Town Hall, 53095 Main Road
TOWN CLERKco) S , "_ i� P.O. Box 1179
<,* �� ', Southold,New York 11971
REGISTRAR OF VITAL STATISTICS Fax(516) 765-1823
��
MARRIAGE OFFICER � � ® �
RECORDS MANAGEMENT OFFICER :;. �s Iii Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER .'I
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3713-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner THE COVE AT SOUTHOLD
Mailing Address 1 305 MEADOW COURT #35
Mailing Address 2
City St Zip SOUTHOLD NY 11971-0000
Property Address 1 MEADOW COURT
Property Address 2
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 000-000-0000
Tax Map No. section 87.01 block / lot
Cross Street BAYV I EW ROAD
Issue Date: 10/30/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
•i i..
OFFICE bF THE TOWN CLERK ��OFQ(K '-
` Town of Southold �% CQG_ Application No.2 /43
Judith T. Terry, Town Clerk /
Town Hall, 53095 Main Road -< $10.00 - Residential �/
P. O. Box 1179 v' , ' M :' $25.00 - Non-Residential
Southold, New York 11971 O �' ��`,
Telephone "lei4 �� l
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE / C) ?(
OWNER NAME: ---iL CJS �. O 6
'OWNER MAILING ADDRESS: �05r ear otu Q-1-,- 4-�E'
��4 o , N�/ L•►u u (
_.O_WNER PROPERTY ADDRESS:
OWNER TELEPHONE NUMBER:
TAX MAP NO. : Section '/S7.0 ) Block Lot
CROSS STREET:
i
TYPE OF SYSTEM: Septic Tank / New Existing
g
Cesspool New Existing
Residential Non-Residential
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.)
i
ItzitAs....2.....
/I, 14_\?AA4cia j
S': ature of Applicant
RECEIVED BY: ,,e ,A'' .
Town, lerk's Office - --
DATE: