HomeMy WebLinkAboutDunhuber (2) JUDITH T. TERRY : Town Hall, 53095 Main Road
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TOWN CLERK ® P.O.r=T t Box 1179
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER � � � Southold, New York 11971
� Fax (516) 765-1823
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 2091-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner DUNHUBER, LORRAINE
Mailing Address 1 P. O. BOX 1288
Mailing Address 2
City St Zip CUTCHOGUE NY 11935-0000
Property Address 1 400 LITTLE PECONIC BAY ROAD
Property Address 2
City St Zip CUTCHOGUE NY 11935-0000
Owner Telephone No. 914-664-0439
Tax Map No. section 111 .00 block 14 lot 11 .000
Cross Street SAISLORS LANE
Date_Of Last Pump Out 0/00/00
Issue Date: 4/19/93 Judith T. Terry
Southold Town Clerk -
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK �c��FF�(�'�-
I\ Town of Southold 0��� ` ,y We:
- Application No.
gg��' dith T. Ter,ry, Town Clerk . •,gt . i i, t
*-°�Pown Hall, 53095 Main Road *= 1 $10.00 - Residential
P. O. Box 1179 c illi
cn �'tj ,�• ��` $25.00 - Non-Residential
Southold, New York 11971 O 3® A' ' "Telephone *.01.24.- ,,e.)-0.1
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ 1 .
6' ,
DATE j 7/2:/93
1
\ OWNER NAME: "C",74-)C- ) ,LI /6L'i
1
OWNER. MAILING ADDRESS: P. 0 . /464--4/ /c)-- $
OWNER PROPERTY ADDRESS: FA /
c
1L19 , //935
v
N o OWNER TELEPHONE NUMBER: 9/4/ 0-1
TAX MAP NO. : Section 3 Block Lot 7
CROSS STREET: ie
TYPE OF SYSTEM: Septic Tank ,V New Existing
Cesspool 3 New Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: Arirll ,—,46..c._ !
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.)
067,-C-a- C4t, A..alf `
Signature of Applicant
5 ,i
feet
RECEIVED BY: al
Town erk's Office ,�
0
DATE: zv
Cie-4-a v'