HomeMy WebLinkAboutPisacano, Gaspar ,I�,�o��S0Ff0(,�eo,
ELIZABETH A. NEVILLE _� 'y� Town Hall, 53095 Main Road
TOWN CLERK ; H P.O. Box 1179
REGISTRAR OF VITAL STATISTICS Southold, New York 11971
MARRIAGE OFFICER `� 1i �����, Fax (631) 765 6145
RECORDS MANAGEMENT OFFICER =_ Ql �a� Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
SOUTHOLD 1MIREINATIBTE113INDSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4105-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner PISACANO, CASPAR & ADELINE
Mailing Address 1 16405 ROUTE 48
Mailing Address 2
City St Zip CUTCHOGUE NY 11935-0000
Property Address 1 16155 ROUTE 48 (E911 ADDRESS)
Property Address 2
City St Zip CUTCHOGUE NY 11935-0000
Owner Telephone No. 631-734-1045
Tax Map No. section 101 .00 block 1 lot 15.001
Cross Street ALVAHS LANE
Issue Date: 8/29/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
••
OFFICE OF THE TOWN CLERK �FFO
TOWN OF SOUTHOLD O�Q�J �C Appli cation No.e//aL
ELIZABETH A.NEVILLE,TOWN CLERK $10.00 - Residential
P.O.BOX 1179
oz€
SOUTHOLD,NEW YORK 11971
$25.00 - Non-Residential
Telephone * •
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK o CESSPOOL
Operation Permit No.
Fee $ /m,00 �t
DATE *Di
OWNER NAME: / ccio Cosprr # IOP *hen"n e'l` u& eL.SQ03/10
OWNER MAILING ADDRESS: /(o4/D5 f?*e �b
Cuirho8 e /L!y 111935-/3 5
OWNER PROPERTY ADDRESS: /(o4(05
CciktuNot ivy IIQ33--i0Y.S
OWNER TELEPHONE NUMBER: 63 1 - - 76 6 g'
TAX MAP NO. : Section 101, 00 Block / Lot /S, 00 /
CROSS STREET: A /iohS Lane_ (&?5+) /Wim sick of l2
TYPE OF SYSTEM: Septic Tank New Existing IN
Cesspool )( New Existing Addition
Residential X 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.)
qS` -+o rl%ddl'e Road
W` -Fo Ncr}Yl FAS- Corrw (4 Resder sial home_
SO' 4o tjes+ LUN of (Sokol))EA s4- Ne�Ghb C wctl� •
/, / faaee9.4t,62._)
' -bpropLivc)t 30'40 80KeNS c oa%I( F) Sign ture • , Appcant
25` Ge-hwee,v Poo 1S
RECEIVED BY:
Town Clerk's Office
DATE:
r ------ ---- -- - --- —
•
TQ NI
R
N Y. tn
TU . L �.
v - .„. 4 _...- EU1ZVEY s •+Z te
�i.6L+420 E 121.67
-_. .pfS - • NIO
m �+ ATy °d A D EL i ' '
._ . DA,..,. 1-----• 2 A.-5TEPNEP) S P►save..lvtt
m „,,..."1: ....., '
MAT TI { barcxi'1 Kehl -P►sacawt�
7.
,`W,�t OF U F ✓ �.!�` .” of �tv c •f St h 1 d i NH- -
iii
4.C3 Gal N
1
..
,.._., //
, ,
. , _ _ _ , , f 3C.
t t rii t j - - ., /
. 1 ,...1 1 . a-- . -"a 14 ‘ • v i // •
f%�STY . ?I:4i
jr
.-,TL1.t0_ 6 .
... 14 _ ielit AIL `1 r,L.E5Qt•I*..
Y
'4----- 561`19 2Q V.I _ 124.4 3614.6670 ALVA1.4� LANE � A'-.22,443 5.F.
ci1cONPYPE
X1/
•
NI1DDLE CC. •:) ROAD
4 New) 4 S' Medd Ienad i
4. , _ P ' -F0 Fn•dd1e 2d. `' - j
r
itt:
h •,.
SO' - 4t, Wes4 wo,11 04- •,e burs ouse . n
a
NQTES., -- JA2ANT'. • D to C ,�'7(1-LE INSURANCE Cbz..,:
t SUFF.CO.TASt MAP DATA 1000-Is1-I-P/015. " •'IQ THE 5CC}1"NOt� 5AVI1 5 -% r.;le,_gTOTHEOWNER5
+ `i. Unaornor atreranon or addition -...-
" TITI.L Co,, f90.850a-0139.1 :n:n•a i :f a noietion of �h�St-112V EYED: #, - APQ IL 1g aig$5.
. s,.,_.. .. SOMOM • of the New York Stag :.ru- i
r Education
q�`• - - r,.n,es of fur#SY malt not beudn __- 1
. .V .. the sand sur or-e inked seat or ,;w - t -
en,hossed :I shall not be eortslder.Q t-
• ,
x '. to be s veli. us copy. 7 �-�- .. _�-Lyr ['
q Guarantees ;heated hereon shell rtel
�'1 _ ..; „, or,,to the..rsonfor whom die survey _____ _ .
t 8, ',reoared. nd on his behalf to the -
• ‘7.4%.--- ,'.come .governmeatoinom,and LIC.C/ tW5IIgVEYQ:S25- . ,_i Gr2[-ENP0f2T Y
ending met moon listed hereon end �-------- --_- „'i�'
n rhe asaig ,as of the landing mid-
,.o., Guaren ees Cr.not transferable