HomeMy WebLinkAboutBrooks (2) /zzc,...-•".
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,-rte: Town Hall, 53095 Main Road
- � y � ` P.O. Box 1179
�' 0t' Southold, New York 11971
JUDITH T.TERRY its � o°' TELEPHONE
TOWN CLERK (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. 769-R Residential X Non-Residential
Fee $ 10. 00 Septic Cesspool X
New Existing X
Name Of Owner BROOKS, RICHARD E.
Mailing Address 1 255 KNOLLWOOD LANE
Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
Property Address 1 255 KNOLLWOOD LANE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-4858
Tax Map No. section 107.00 block 6 lot 11. 000
Cross Street GRAND AVENUE
Date Of Last Pump Out 0/00/00
Issue Date: 7/22/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK i5�FFULj' '
Town of Southold V� Mire'
Application No. 7 ,7
_
Judith T. Terry, Town Clerk �`� �47
Town Hall, 53095 Main Road f `m -'� 7 Residential
va .�r
P. O. Box 1179 �.��'�'�F' �i �' Non-Residential
Southold, New York 11971 O ® 4`" -kc�1`,
Telephone _°j * N�
(516) 765-1801
REINED
TOWN OF SOUTHOLD
II Ing 2.7 1988
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
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