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Home My WebLink AboutPappacoda, Frank /040° 10 ELIZABETH A. NEVILLE ��h� y �� Town Hall, 53095 Main Road TOWN CLERK % o P.O. Box 1179 H Z Southold New York 11971 REGISTRAR OF VITAL STATISTICS ' MARRIAGE OFFICER ,ji �, Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER � "'/Qi 4��'�,,I 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. 4198-R Residential X' Non-Residential Fee $ 10.00 New X Existing Name Of Owner PAPPACODA, FRANK Mailing Address 1 547 KIME AVENUE Mailing Address 2 City St Zip WEST ISLIP NY 11795-0000 Property Address 1 2995 LAUREL TRAIL Property Address 2 City St Zip LAUREL NY 11948-0000 Owner Telephone No. 516-542-1083 Tax Map No. section 125.00 block 4 lot 24.010 Cross Street Issue Date: 4/16/03 Elizabeth A. Neville Southold Town Clerk (TOWN SEAL) OFFICE OF THE TOWN CLERKSVFFO(K ELIZABETH ATOWNNE ILLE,OF HApplication No.OWN CLERK �OLD � CO - �� f P.O.BOX 1179 $1�.�� Residential SOUTHOLD,NEW YORK 11971 $25.10 - Non-Residential Telephone 'Oj Jig `P9,/1 (516) 765-1801 'o TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION RECEIVED for a 1 A OPERATION PERMIT SEPTIC TANK or CESSPOOL SoutFhold town Clerlt Operation Permit No. -2g-5-3 Fee $ 10 . Up DATE 3/103 OWNER NAME: Irr�-AN)(-- A,,P/4ce0fk OWNER MAILING ADDRESS: 5-`/7 � `/7 ,4� e f' )��veAdL,,A., i e-5-- .-275/,%49 /V I OWNER PROPERTY ADDRESS: Z ,;25r OWNER TELEPHONE NUMBER: 56. 5-9.01- /U8'3 TAX MAP NO. : Section /oZ Block Y Lot 0)5/- ©/O , CROSS STREET: TYPE OF SYSTEM: Septic Tank New Existing CesspoolNew 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.) Applicant Signature of Applicant RECEIVED B)c))/// Town Clerk's Office DATE: