HomeMy WebLinkAboutPymm ‘``' 4:;\
9Town Hall, 53095 Main Road
P.O. Box 1179
�®
Southold, New York 11971
JUDITH T.TERRY i4011 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. 1238-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New X Existing
Name Of Owner PYMM, WILLIAM
Mailing Address 1 9 EAST HIGH ROAD
Mailing Address 2
City St Zip PORT WASHINGTON NY 11050-0000
Property Address 1 REEVE AVENUE R.O.W.
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-365-9642
Tax Map No. section 122.00 block 9 lot 7.009
Cross Street NEW SUFFOLK AVENUE
Date Of Last Pump Out 0/00/00
Issue Date: 8/29/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK
Town of Southold GApplication No.
Judith T. Terry, Town Clerk x � 10.00 - Residential
Town Hall, 53095 Main Road F, $
P. O. Box 1179 cry z, .
�y $25.00 - Non-Residential
Southold, New York 11971 p:�® =
Telephone •Q( � •
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE Aug. 28th, 1989
OWNER NAME: William Pymm • •
OWNER MAILING ADDRESS: 9 East High Road
Port Washington, N.Y. 11050
OWNER PROPERTY ADDRESS: Reeve Ave. R.O.W. (Camp Mineola Road)
Mattituck, N.Y. 11952
OWNER TELEPHONE NUMBER: 516-365-9642
TAX MAP NO. : Section 122 . 00 Block 9 Lot 7. 009
CROSS STREET: New Suffolk Avenue
TYPE OF SYSTEM: Septic Tank X New X Existing
Cesspool X New X Existing
X
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: N/A
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.)
•
•nature of Applicant
RECEIVED BY:
ii;_-_:!Le Town Clerk's Office
DATE: AHG29l98
town aero'' so ifild
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