HomeMy WebLinkAboutZalnek, Joseph ,,%S�FFO�,�►c
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ELIZABETH A. NEVILLE �� � y Town Hall, 53095 Main Road
TOWN CLERK o P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
Fax(631) 765-6145
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER =W�l 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. 4172-R Residential x Non-Residential
Fee $ 10.00 New X Existing
Name of Owner ZALNEK, JOSEPH
Mailing Address 1 68-39 MANSE STREET
Mailing Address 2
City St Zip CUTCHOGUE NY 11935-0000
Property Address 1 700 BROADWATERS ROAD
Property Address 2
City St Zip CUTCHOGUE NY 11935-0000
Owner Telephone No. 631-298-0000
Tax Map No. section 104.00 block 10 lot 2.001
Cross Street VANSTON ROAD
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Issue Date: 11/26/02 Elizabeth A. Neville
Southold Town clerk
(TOWN SEAL)
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. .
OFFICE OF THE TOWN CLERKOC��FFUi`;-TOWN OF SOUTHOLD _ � '
ELIZABETH A.NEVILLE,TOWN CLERK Application No.,
$10.00 - Residential V
P.O.BOX 1179
SOUTHOLD,NEW YORK 11971 � $25.00 - Non-Residential
Telephone 70 if s�0��;
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(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
RECEIVED
for
OPERATION PERMIT NOV 8 "n"
SEPTIC TANK or CESSPOOL
Southold Town Clerk
Operation Permit No.
Fee $
DATE I v f3 /c) 2_
OWNER NAME: V o $ P H e\r--
OWNER MAILING ADDRESS: 700 Z/LoPtOWA-Toc_S (Zd if")
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OWNER PROPERTY ADDRESS: (a- 31
11375
OWNER TELEPHONE NUMBER: g`18
TAX MAP NO. : Section 1 v Block 10 ( Lot - _ ,
CROSS STREET: �,� \ A- -J STh
TYPE OF SYSTEM: Septic Tank 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.)
009,
Signature of App icalr
RECEIVED B
Town Clerk's Office
DATE:
Town Of Southold
P.O Box 1179
Southold, NY 11971
* * * RECEIPT * * *
Date: 11/12/02 Receipt#: 5405
Transaction(s): Subtotal
1 Septic Permit-Operation - Resid. $10.00
Check#: 5405 Total Paid: $10.00
Name: Zalner, Joseph &Judith
700 Broadwaters Rd.
Cutchogue, NY 11935
Clerk ID: LYNDAB Internal ID:63983