HomeMy WebLinkAboutHohn r ,
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tTown Hall, 53095 Main Road
�' P.O. Box 1179
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1Southold, 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. 1337-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner HOHN, HARRY G. AND JANET L.
Mailing Address 1 200 EAST 66TH STREET
Mailing Address 2 APT. C1203
City St Zip NEW YORK NY 10021-0000
Property Address 1 8960 PECONIC BAY BOULEVARD
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 212-576-5077
Tax Map No. section 126.00 block 5 lot 6.000
Cross Street BRAY AVENUE
Date Of Last Pump Out 0/00/00
Issue Date: 12/06/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
- n . •
'OFFICE OF THE TOWN CLERK t‘cl\FMir ,
Town of Southold COG Application No. 05-7
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road
..:4•41 .r`
4•,�4 _ $10.00 - Residential
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P. O. Box 1179 c4 ;~-- ^fir ,
:� ...,. �• z � $25.00 - Non-Residential
Southold, New York 11971 OS� s . � ��`,
Telephone ( `� ��
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(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE T)aramher 4, 1989
OWNER NAME: HARRY G. AND JANET L. HOHN
OWNER MAILING ADDRESS: 200- East 66th Street, Apt. C1203 = m.
New, York, New York 10021
OWNER PROPERTY ADDRESS:
8960 2 o iBay Blvd.
Mattituck. New York
OWNER TELEPHONE NUMBER: 212-576-5077 or `212-758-2557
TAX MAP NO. : Section 126' i Block 5 Lot ' 6
-CROSS STREET: Bray Avenue
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing - xxx
Residential xxx Non-Residential
DATE OF PREVIOUS PUMP-OUT: July 1989? •
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.)
4".,dJA.A....411111, _
Si itt•77' of Applicant
RECEIVED BY: ` -
Town Clerk's Office
DATE:
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