HomeMy WebLinkAboutDickerson OFFICE OF THE TOWN CLERK 4. ic�vFFOIJr f-
Town of Southold �� lj
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road _
P. O. Box 1179
Southold, New York 11971 `Y .•
Telephone ' 14felP
(516) 765-1801 '
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT -
SEPTIC TANK or CESSPOOL
Operation Permit No. 263 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool x
NAME OF OWNER: Allan C. Dickerson
OWNER MAILING ADDRESS: 2255 Grand Avenue
Mattituck, New York 11952
OWNER PROPERTY ADDRESS: 2255 Grand Avenue
Mattituck, New Yo'rk:.
OWNER TELEPHONE NUMBER: • 516-298-4956
TAX MAP NO. : Section 107- Block 8 Lot 3
CROSS STREET: S/W Corner of Woodcliff Drive
TYPE OF SYSTEM: Septic Tank New - Existing
Cesspool X New Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: Approx. 1982 -1983
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Judith T. Terry
Southold Town Clerk
DATE: April 7, 1987
(TOWN SEAL)
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