Loading...
HomeMy WebLinkAboutLikokas cOf Town Hall, 53095 Main Road ) P.O. Box 1179 s� � Southold, New York 11971 Y JUDITH T.TERRY _®j �s ,. TELEPHONE FOWN CLERK � (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. 829-R Residential X Non-Residential Fee $ 10. 00 Septic Cesspool X New Existing X Name Of Owner LIKOKAS, ORESTIS Mailing Address 1 88-23 RIDGE BLVD Mailing Address 2 City St Zip BROOKLYN NY 11209-0000 Property Address 1 MAIN ROAD Property Address 2 City St Zip EAST MARION NY 11939-0000 Owner Telephone No. 218-238-3151 Tax Map No. section 31. 00 block 3 lot 10. 000 Cross Street STARS ROAD Date Of Last Pump Out 0/00/00 Issue Date: 9/14/88 Judith T. Terry Southold Town Clerk (TOWN SEAL) litowow eL cOf UL co, 1 Town Hall, 53095 Main Road P.O. Box 1179 ®r +� Southold, New York 11971 JUDITH T.TERRY = � °�6',0. TELEPHONE TOWN CLERK (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. 830-R Residential X Non-Residential Fee $ 10. 00 Septic Cesspool X New Existing X Name Of Owner LIKOKAS, ORESTIS Mailing Address 1 88-23 RIDGE BLVD Mailing Address 2 City St Zip BROOKLYN NY 11209-0000 Property Address 1 MAIN ROAD Property Address 2 City St Zip EAST MARION NY 11939-0000 Owner Telephone No. 718-238-3151 Tax Map No. section 31. 00 block 3 lot 10.000 Cross Street STARS ROAD Date Of Last Pump Out 0/00/00 Issue Date: 9/14/88 Judith T. Terry Southold Town Clerk (TOWN SEAL) (6®6j Ir cr4 Town Hall, 53095 Main Road ��`� P.O. Box 1179 _® toti° i4 Southold, New York 11971 ®�JUDITH T.TERRY ~=. TELEPHONE TOWN CLERK (516) 765-1801 REGISTRAR 01-VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 831-R Residential X Non-Residential Fee $ 10. 00 Septic Cesspool X New Existing X Name Of Owner LIKOKAS, ORESTIS Mailing Address ,1 88-23 RIDGE BLVD Mailing Address 2 City St Zip BROOKLYN NY 11209-0000 Property Address 1 MAIN ROAD Property Address 2 City St Zip EAST MARION NY 11939-0000 Owner Telephone No. 718-238-3151 Tax Map No. section 31. 00 block 3 lot 10. 000 Cross Street STARS ROAD Date Of Last Pump Out 0/00/00 Issue Date: 9/14/88 Judith T. Terry Southold Town Clerk (TOWN SEAL) to �� � ' OFFICE OF THE TOWN CLERK g' 3 b ���FFO ""` Town of Southold % ;• `�e4'. -- , Application No. 3/ Judith T. Terry, Town Clerk ` + 6 h.G Town Hall, 53095 Main Road . :�Y '-'4 r: 7 Residential O + Vg-la P. O. Box 1179 to ":�� ram hzi ;• Non-Residential v.Southold, New York 11971 O � Y0"°" �`' Telephone = j • (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ lb. • DATE OWNER NAME: 3,&74& 41/649 OWNER MAILING ADDRESS: ' gr--a3 / gevi 8e0off id, 0 OWNER PROPERTY ADDRESS: aidDail , OWNER TELEPHONE NUMBER n dZ3r-3/S� Jo7-O 19� , rTAX MAP NO. : Section / Block `? ✓✓ Lot /(7 0 CROSS STREET: 6c c , TYPE OF SYSTEM: Septic Tank / New Existing Cesspool V New Existing Residential /��}} Non-Residential 9 DATE OF PREVIOUS PUMP-OUT: / '7 j 3 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.) e4....4 7 L7----—,Tf/z;7-,....., . Signature of Applicant RECEIVED BY: Town Clerk's Office DATE: - 1 I p v a