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Home My WebLink AboutBifulco 1 . offat Ill C�® iU �� ELIZABETH A.NEVILLE � Town Hall, 53095 Main Road TOWN CLERK ` ® P.O. Box 1179 Bei REGISTRAR OF VITAL STATISTICS n Southold, New York 11971 MARRIAGE OFFICER C, O Fax Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER `��®� ss22 �v� 1, Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 4014-R Residential X Non-Residential Fee $ 10.00 New X Existing Name Of Owner BIFULCO, HARRY P. III Mailing Address 1 4730 OAKLAWN AVE. EXT. Mailing Address 2 City St Zip SOUTHOLD NY 11971-0000 Property Address 1 4730 OAKLAWN AVE., EXT. Property Address 2 City St Zip SOUTHOLD NY 11971-0000 Owner Telephone No. 516-765-9008 Tax Map No. section 700.00 block 900 lot 49.000 Cross Street CLEARVIEW AVENUE Issue Date: 3/08/00 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) " ... OFFICE 01'THE TOWN CLERK S�FFO(,��;" • *TOWN OFSOUfHOLD `, Application No. 1/et /(. ELIZABETH A.NEVILLE;TOWN CLERK $10.00 - Residential t P.O.BOX 1179 *.$ $25.00 - Non-Residential SO6THOLD,NEW YORK 11971 -- Telephone - , �j * •No-s" (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICAT ION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ • DATE Z= ZICZ) OWNER NAME: gDP5 Q Pj C rit OWNER MAILING ADDRESS: 973 4K1.4,AiU AYE I+XT-• SOU- by 1197 OWNER PROPERTY ADDRESS: nn - OWNER TELEPHONE NUMBER: 5.-(6 -765-96-06 TAX MAP NO. : Section 7Q Block 09 Lot CROSS STREET: CLcv, ./ TYPE;OF)SYSTEM: Septic Tank v/ New 17 Existing Cesspool L New ✓ Existing Residential V Non-Residential 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.) ..i�� Ai . e, S •,nat re of pp icant RECEIVEDuBY: ==_' . •. Town Clerk's Office • DATE: SCDHS Ref. # R10-97-0030 - 165 `; �0/F Z SCI� A 0 CV S 83.48'00" E J � ' � 0 2'N 'PIPE �V 0.2'W " ' a. g ...,.................„. FE 1 chain link fence 1�;©(�' - _� FE rrj 0 1'N PIPE FE , ''rr,, 0 3'W dirt a�vepy M , I k . , S$ / ,n , , j _ I I< En'l .W G2 sr / ri 0o2 - a- 4.6; __ ze z „ __ _ .• 0 ,,-,_ — -- ,ce.,-, R - z,:i _ ! . . 6-,> ---Z '-, _?.- 0 ' ; - , 2s z. 3 Z` 1 INN - R ' ---= _35 9' S . g . . PIPE S.1 N - ,I N 87.06'30"- w - I -- _ N i , I /5047' PIAS O mi N/p/F, S . ni _ o 16 • ''" • - CLEW A VE.