HomeMy WebLinkAboutSantora, Joseph %S�FFOL/r
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ELIZABETH A.NEVILLE '���h�0 Gy Town Hall, 53095 Main Road
TOWN CLERK o P.O. Box 1179
REGISTRAR OF VITAL STATISTICS ' Southold,New York 11971
�� Fax(631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER `_y__Q! �aO,,�� Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER _ ,�'. southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4230-R Residential x Non-Residential
Fee $ 10.00 New x Existing
Name of Owner ; SANTORA, JOSEPH
Mailing Address 1 PO BOX 696
Mailing Address 2
City St Zip GREENPORT NY 11944-0000
Property Address 1 280 SHORT LANE
Property Address 2
City St Zip EAST MARION NY 11939-0000
Owner Telephone No. 631-765-5498
Tax Map No. section 30.00 block 2 lot 9.000
Cross Street LONG WAY
Issue Date: 1/28/04 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
s
......
OFFICE OF THE TOWN CLERK
TOWN OFSOt1THOLD Application No. 230
ELIZ48ETH A.NEVILLE,TOWN CLERK $10.00 - Residential
P.O.BOX 1179 8
SOUTHOLD,NEW YORK 11971 $25.00 - Non-Residential
Telephone Oj *
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 6'4 ?
Fee $ /0
DATE 19-- - 2
OWNER NAME: , 'f((ri 9.4/v/ 0 /e 4--
OWNER MAILING ADDRESS: 0 bc.) ) o9‘
64fi;� �J6,2, ��� 11 Y yy
OWNER PROPERTY ADDRESS: c2fr0 ! 564u/et— G,i,vC
OWNER TELEPHONE NUMBER: r765---- Sy a
TAX MAP NO. : Section 3�' 0') Block Lot T • oo�
CROSS STREET: 7,/_.4.)
TYPE OF SYSTEM: Septic Tank New V Existing
Cesspool New ) Existing
Residential // 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.)
Sfrfnalure of Applic
RECEIVED BY: •
Town Clerk's Office
DATE:
a
/0
ARTCO DRAINAGE CORP .
P.O. BOX 1132 MATTITUCK, NEW YORK 11952
(631) 298-9660 • FAX (631) 298-2291 r-
L X C /t:c/84 6 (—
Certificate of sewage dispose system by installer (-0�`-,-
Health Dept Reference number R10-02-0122 •
Suffolk tax map#: Dist: 1000 Sect(s) 30 Blk(s) 02 Lot(s) 09
Project name or Address: The Short Lane
Subdivision Name&Lot# 8
Applicant's Name Mr. Joseph Santora
Description of system installed:
Septic Tank
Volume (gallons ) 1000
Shape rectangle
Name of Precast manufacturer: Coastal Pipeline
Leaching Pools
Number of pools - 1
Diameter and depth- 8' x 12'
Name of Precast manufacturer: Coastal Pipeline
Other
Attach or sketch below the measurements from building corners to the access covers of disposal
system. n
r � I`r
I
I hereby certify that the subsurface sewage disposal system, described herein, has been installed
by me in accordance with the plans and standards of the Suffolk County Department of Heath
• Services: and is operationa ,10°.°4071
Installer '' 11
Signature Date '
Artco Drainage Corp 631-298-9660
Consumer Affairs License Number 206W