HomeMy WebLinkAboutCleaves Point Village •
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OFFICE OF THE TOWN CLERK Fa
Town of Southold QC) -�COIj
Judith T. Terry, Town Clerk uj>• ��
Town Hall, 53095 Main Road = w {4,
P. O. Box 1179 i cr) nq virat,,a4 g �:
Southold, New York 11971 `‘
Telephone OligiCN�
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 507 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool x
NAME OF OWNER: Cleaves Point Village Condo Assoc.
OWNER MAILING ADDRESS: P.O. Box 29
Greenport, New York 11944
OWNER PROPERTY ADDRESS: 2820 Shipyard Lane
East Marion, New York
OWNER TELEPHONE NUMBER: 516-477-2323
TAX MAP NO. : Section 38.02 - Block 1 Lot 45
CROSS STREET: Main Road ( State Road 25 )
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: None
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Southold Town Clerk
DATE: December 2, 1987
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK �F�'p '
Town of Southold X05 �. . �Ql'' , Application No. `���
Judith T. Terry, Town Clerk Z "_ r , y
Town Hall, 53095 Main Road .ia-' ; :4 1 Residential
P. O. Box 1179 �} ''- ' `' Non-Residential
Southold, New York 11971 O Y •�`
Telephone 1Yo.��` "ye.# 'f
(516) . 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
10r
OPERATION PERMIT _ -
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE // 7
NER NAME: �.e/ '/e"$ /fir Vi - 0yr6c ,l�• SC-
OW
OWNER MAILING ADDRESS:____PC
lir NP69d2 i V. //13?/'-`" -
OWNER PROPERTY ADDRESS: zg ® /7//gygl'P 04/44/&.
5...7- "it-efAte/6 'r heiy //,,y9
OWNER TELEPHONE NUMBER: 77- rSe_5
TAX MAP NO. : Section 3 ? Block ,--6 Lot
CROSS STREET:
TYPE OF SYSTEM: Septic Tank ii,./- New Existing 1.,......."------
Cesspool
.,......."----'Cesspool New Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: /451?"/E
LOCATION MAP: Must be attached hereto before permit may be issued.
PI
(Locate building and system; give north arrow and feet
of distance, approximately, to building and closest road.)
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OP ��'S711=� / /
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RECEIVED BY:
Rietv6lerk's Office ,
DATE: DEC ®2 -::9
Town Cork Southold