HomeMy WebLinkAboutDykovitz Town Hall, 53095 Main Road
-60 .•% P.O. Box 1179
'� Southold, New York 11971
JUDITH T.TERRY ' FAX(516)765-1823
TOWN CLERK TELEPHONE(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. 1449-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner DYKOVITZ, PETER AND WIFE
Mailing Address 1 BOX 107
Mailing Address 2
City St Zip EAST MARION NY 11939-0000
Property Address 1 8300 MAIN ROAD
Property Address 2
City St Zip EAST MARION NY 11939-0000
Owner Telephone No. 516-477-0324
Tax Map No. section 31 .00 block 7 lot 2.000
Cross Street OLD ORCHARD LANE
Date Of Last Pump Out 5/18/82
Issue Date: 5/07/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK • � �FFe1, �'-
Town of Southold 'W"3 n CQ = Application No. '1("M
Judith T. Terry, Town Clerk 05`` _*►: 1
Town Hall, 53095 ,Main Road � '�' a��� :� $10.00 - Residential
p. 0. Box 1179 "! ; 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 $ v (�
DATE April 10, 1990
OWNER NAME: DYKOVITZ, Peter & wf. • •
OWNER MAILING ADDRESS: Box 107
East Marion, N.Y. 11939
OWNER PROPERTY ADDRESS: " 8300 Ma.i <•Road`
East Marion, N.Y.
• OWNER TELEPHONE NUMBER: 477-0324
TAX MAP NO. : Section 31 Block 7 Lot 2
CROSS STREET: 2nd house east of Old Orchard Lane
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing X
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: May 18, 1982
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.)
►O',
Si• ature Applicant
RECEIVED BY: 41/
own Clerk's 0-rice
DATE:
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