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Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
JUDITH T.TERRY �zs op 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. 1244-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner FEST, DIANE E.
Mailing Address 1 P. O. BOX 999
Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
Property Address 1 370 NORTH DRIVE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-4633
Tax Map No. section 106.00 block 6 lot 30.000
Cross Street BAYV I EW ROAD
Date Of Last Pump Out 0/00/00
Issue Date: 9/14/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK S\ FD(,'f'=
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19-Insert sketch of location of Water & Sewerage Facilities with accurate dimensions .
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