HomeMy WebLinkAboutDaphnides 0x,,0Gy,;
JUDITH T. TERRY Z Town Hall, 53095 Main Road
TOWN CLERK T ; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS trA Southold, New York 11971
MARRIAGE OFFICER Fax (516) 765-1823
440 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. 3133-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner DAPHNIDES, CHRISTO AND HELEN
Mailing Address 1 3 BATES ROAD
Mailing Address 2
City St Zip GREAT NECK NY 11020-0000
Property Address 1 350 STRATMORE ROAD
Property Address 2
City St Zip EAST MARION NY 11939-0000
Owner Telephone No. 516-466-5947
Tax Map No. section 21 .00 block 1 lot 10.000
Cross Street ROCKY POINT ROAD
Date Of Last Pump Out 0/00/00
Issue Date: 10/14/93 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
•-a •
OFFICE OF THE TOWN CLERK3/33
Town of Southold O�� CQ� � Application No.
Judith T. Terry, Town Clerk � � �- tA
Town Hall, 53095 Main Road a - $10.00 - Residential x
P. O. Box 1179
�' � <-_ - '��; $25.00 - Non-Residential
Southold, New York 11971 OO �0� "$
Telephone _ -1411 y► '�
(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 Sept. 24, 1993
OWNER NAME: Christo & Helen Daphnides
OWNER MAILING ADDRESS: 3 Bates Road
Great Neck, NY 11020
OWNER PROPERTY-,ADDRESS: " T 350 Stratmore Road
East Marion, NY
OWNER TELEPHONE NUMBER: 516 466 5947
TAX MAP NO. : Section 21 Block 1 Lot 10
CROSS STREET: Rocky Point Road
TYPE-OF SYSTEM: Septic -Tank— _ - - New Existing
Cesspool x New Existing x
Residential x Non-Residential
DATE OF PREVIOUS PUMP-OUT:• -
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.)
• / IMPORTANT NOTE: NO WASTE WAS REMOVED
Only the grease pipe was replaced .
which had become corroded. Al wA
II
Signature of App icant
RECEIVED BY: . __
Town Clerk's Office
DATE: - - - -
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