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''1%! Town Hall, 53095 Main Road
Jyp E ` P.O. Box 1179
.00 Southold, New York 11971
JUDITH T.TERRY N 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. 1023-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner TABOR, HAROLD C.
Mailing Address 1 P. O. BOX 132
Mailing Address 2
City St Zip ORIENT NY 11957-0000
Property Address 1 SKIPPERS LANE
Property Address 2
City St Zip ORIENT NY 11957-0000
Owner Telephone No. 516-323-3648
Tax Map No. section 25.00 block 1 lot 20.000
Cross Street VILLAGE LANE
Date Of Last Pump Out 0/00/67
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Issue Date: 2/15/89 Judith T. Terry
Southold Town Clerk
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