HomeMy WebLinkAboutAmerican Tap and Tool (2) 4101
��,� Town Hall, 53095 Main Road
,01
141 P.O. Box 1179
y o 4' Southold, New York 11971
JUDITH T.TERRY 4A�;�®� ` �� TELEPHONE
TOWN CLERK
4%k` (516)765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3567-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner AMERICAN TAP AND TOOL
Mailing Address 1 STEVE RODAY
Mailing Address 2 P. O. BOX 1680
City St Zip MATTITUCK NY 11952-0000
Property Address 1 940 WOODCLIFF DRIVE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-1078
Tax Map No. section 107.00 block 8 lot 10.001
Cross Street WESTVIEW ROAD
Issue Date: 12/27/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
w.
.40
OFFICE OF THE TOWN CLERK• I°
OFFICE
Town of Southold �o CQG Application No.,3 `J ' 7
Judith T. Terry, Town Clerk ,cam
Town Hall, 53095 Main Road
:� . . $10.00 - Residential !/
.
P. O. Box 1179 cn ;. ►fin ;' $25.00 - Non-Residential
Southold, New York 11971 ‘15) ` 0f"°`" ����`
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE ID- 'ol?J
OWNER NAME: ci U2 �d,J� - fk/H c/iW
OWNER MAILING ADDRESS: I d / 1 ,'YO
vYl 877771.1 cc AA/ 89r-1--
OWNER
/9& —OWNER PROPERTY ADDRESS . 940 Cchn®/,CL-/ P
1 in 4177 Tu c/C /�
OWNER TELEPHONE NUMBER: -/O 72 6., d7ezig
TAX MAP NO. : Section /07 Block f Lot /Die /
CROSS STREET: W e5 7L1��`PC� r�c�r
TYPE OF SYSTEM: Septic Tank - New Existing
Cesspool . New Existing
Residential j/ Non-Residential 1
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.)
Signature of Applicant
RECEIVED BY:
Town Ch ;EOVe
DATE: DEC 2 71996
13 ,5i/ So tho d Town Clerk