HomeMy WebLinkAboutSlotkin OFFICE OF THE TOWN CLERK • scigQ[x`,'
Town of Southold
Judith T. Terry, Town Clerk —'
Town Hall, 53095 Main Road W =
P. O. Box 1179
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Southold, New York 11971 p` ��0�-��•
Telephone _ �l s [
(516) 765-1801 '-
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. NR4O Residential
Non-Residential X
Fee $ 25.00
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Septic Cesspool X
NAME OF OWNER: Jay, P: Slotkin M.D.
OWNER MAILING ADDRESS: 50 Akerly Pond Lane, Box 1437
Southold, New York 11971
OWNER PROPERTY ADDRESS: 50 Akerly Pond Lane
Southold, New York
OWNER TELEPHONE NUMBER: 516-765-1414
TAX MAP NO. : Section 70 Block 5 Lot 4
CROSS STREET: Corner of Main Road & Akerly Pond Lane
TYPE OF SYSTEM: Septic Tank New Existing - -
Cesspool X New Existing X
Residential Non-Residential X -
DATE OF PREVIOUS PUMP-OUT: November 1985
Judith T. Terry
Southold Town Clerk
DATE: July 15; 1987
(TOWN SEAL) .
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OFFICE OF THE TOWN CLERK �S�FFOC("7=
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