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JUDITH T.TERRY Y ' E /it %, Town Hall, 53095 Main Road
TOWN CLERK ` cej ; ,i P.O. Box 1179
• Prs t Southold,New York 11971
REGISTRAR OF VITAL STATISTICS `® '� s t'
MARRIAGE OFFICER ~ �1� Fax(516)765-1823
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RECORDS MANAGEMENT OFFICER : ®.� #a� 1. Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER — .0•11���
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3746-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner AABR REALTY FACILITES HOLDING
Mailing Address 1 P. O. BOX 560247
Mailing Address 2 15-08 COLLEGE POINT BLVD.
City St Zip COLLEGE POINT NY 11356-0000
Property Address 1 2420 PRIVATE ROAD #18
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 718-321-3800
Tax Map No. section 121 .00 block 4 lot 8.001
Cross Street SOUND AVENUE
Issue Date: 12/16/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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GFFIC,E OF THE TOWN CLERKFOIA.
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Town of Southold , § CQG Application NO
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road ;< $10.00 - Residential X
P. O. Box 1179 to $25.00 - Non-Residential
Southold, New York 11971 O **$
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
•
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ 10.00
DATE December 11, 1997
OWNER NAME: AABR REALTY FACILITIES HOLDING CORP.
OWNER MAILING ADDRESS: 15-08 College Point Blvd. , P.O.Box 560247
College Point, NY 11356
OWNER PROPERTY ADDRESS: 2420 Private Rd. #18, also identified SCTM #1000-121.
-4-8.1
OWNER TELEPHONE NUMBER: (718) 321-3800
TAX MAP NO. : Section 121 Block 04 Lot 008.001
CROSS STREET:,-, Sound Avenue
TYPE OF SYSTEM: ' Septic Tank _New Existing x
Cesspool x New Existing
Residential X 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.)
Si.nature of Applicant
Christopher Weldon, or '•.:` •ealty Facilities
Holding Corp.
RECEIVED BY:
Town Clerk's Office
DATE: '