HomeMy WebLinkAboutHoman S
JUDITH T. TERRY �1 Town Hall, 53095 Main Road
TOWN CLERK P.O. Box 1179
REGISTRAR OF VITAL STATISTICS . 4Southold, New York 11971
MARRIAGE OFFICER � � Fax Fax (516) 765-1823
®���' 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. 1819-R Residential X Non-Residential
Fee `$ 10.00 Septic Cesspool X
New Existing X
Name Of Owner HOMAN, ALFRED E. JR.
Mailing Address 1 1295 PIPES NECK ROAD
Mailing Address 2
City St Zip GREENPORT NY 11944-0000
Property Address 1 1295 PIPES NECK ROAD
Property Address 2
City St Zip GREENPORT NY 11944-0000
Owner Telephone No. 516-477-2244
Tax Map No. section 53.00 block I lot 11 .000
Cross Street ROUTE 25
Date Of Last Pump Out 0/00/78
Issue Date: 12/12/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK 'c1FJFL/=
Town of Southold �% CQG' Application No. /�l
Judith T. Terry, Town Clerk % 1 k y
Town Hall, 53095 Main Road c -'� $10.00 - Residential
-
P. O. Box 1179 cn V ; Mi��` $25.00 - Non-Residential
Southold, New York 11971 - O/16:24*'. ` ,�o ��`
Telephone y1
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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 bee...., to /ei 1
OWNER NAME: ' f l 6', a.44 j k-
OWNER MAILING ADDRESS: ( 2eiS 7i Neck_ ,4 .z,,c/
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