HomeMy WebLinkAboutPershouse, Gayle , %OF S0045,
ELIZABETH A.NEVILLE ,� �Q , Town Hall, 53095 Main Road
TOWN CLERK 4 4; P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ; G ,� Southold, New York 11971
MARRIAGE OFFICER �► �Q �1 Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER a�'. 6,%\
/�� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER = COUNT'1,*�,;#� southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4293-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner PERSHOUSE, GAYLE AND OTHERS
Mailing Address 1 106 ARLINGTON ROAD
Mailing Address 2
City St Zip WOBURN MA 01801-0000
Property Address 1 14895 MAIN ROAD
Property Address 2
City St Zip EAST MARION NY 11939-0000
Owner Telephone No. 781-938-0355
Tax Map No. section 22.00 block 3 lot 38.000
Cross Street DAM POND
Issue Date: 10/20/05 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)