HomeMy WebLinkAboutManzi Homes Inc (15) ,, �OOSOFFO�,�(.0G
ELIZABETH A.NEVILLE '4T'y�; Town Hall, 53095 Main Road
TOWN CLERK ; y • P.O. Box 1179
REGISTRAR OF VITAL STATISTICS v' i Southold, New York 11971
MARRIAGE OFFICER : ,�rL 1��1�, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER 7Q1 �a�,ii Telephone (631) 765-1800
FREEDOM OF INFORMATION OFFICER ���
OFFICE OF THE TOWN CLERK
SOUTHOLD I grrfl4 jlf1SAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 4110-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner MANZI HOMES
Mailing Address 1 P 0 BOX 702
Mailing Address 2
City St Zip ROCKY POINT NY 11778-0000
Property Address 1 175 KOKE DRIVE
Property Address 2
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 631-744-1039
Tax Map No. section 78.00 block 7 lot 47.000
Cross Street MAIN BAYVIEW ROAD
Issue Date: 11/15/01 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
•
S.° .. IP/. •
OFFICE OF THE TOWN CLERK C�FFD(,�'
TOWN OF SOUTHOLD ��. OG PPation No. //1
F�LIZABETH A.NEVILLE,TO.WN CLERK C Alit$10.00 - Residential
P.O.BOX 1179
SOUI'HOLD,NEW YORK 11971 ,M $25.00 - Non-Residential
0-01 •Telephone 01 )I(
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
•
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE If6e J
OWNER NAME: mon Z; /40meS
OWNER MAILING ADDRESS: P. O 3o>,
, y //?7P
OWNER PROPERTY ADDRESS: /.___73 /1)k_ DAA,,-e.
Sou hoiri ,0y 11g71
OWNER TELEPHONE NUMBER: J-/L/ _ J Q (6,311
TAX MAP NO. : Section 0 17 p Block 017 Lot 0 y
CROSS STREET: MOCin 1JayA-Qc&d
TYPE OF SYSTEM: Septic Tank IZ New 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.)
J Signature of Applica t
RECEIVED BY: < S
Town lerk's Office
DATE: l f 3 0 /`
74auSCr
cess I;0c a `"-