HomeMy WebLinkAboutWeters OFFICE OF THE TOWN CLERK C,
Town of Southold ry •. .- e
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road
P. O. Box 1179 i`‘j ,:
Southold, New York 11971
Telephone - . ,:st.
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 528 Residential X
Fee $ 10.00 Non-Residential
Septic Cesspool X
NAME OF OWNER: John H. Waters
OWNER MAILING ADDRESS: 394-Stewart Avenue
Garden City, New York 11530
OWNER PROPERTY ADDRESS: 3055 Nassau Point Road (Summer - P.O. Box 327)
Cutchoque, New YOrk 11935
OWNER TELEPHONE NUMBER: 516-734-6844
TAX MAP NO. : Section 104 Block 13 Lot 11
CROSS STREET: Vanston Road
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing x
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: 1986
•
Juditn T. Te
Southold Town Clerk
DATE: December 10, 1987
(TOWN SEAL)
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