HomeMy WebLinkAboutMoglia, John le
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ELIZABETH A. NEVILLE *%‘ Town Hall, 53095 Main Road
TOWN CLERK o - P.O. Box 1179
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REGISTRAR OF VITAL STATISTICS i Southold, New York 11971
MARRIAGE OFFICER `� Fax l� �, Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER = -'/Ql �a��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. 4183-R Residential x Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner MOGLIA, JOHN
Mailing Address 1 10 POPLAR STREET
Mailing Address 2
City St Zip SAYVILLE NY 11782-0000
Property Address 1 475 SNUG HARBOR ROAD
Property Address 2
City St Zip GREENPORT NY 11944-0000
Owner Telephone No. 631-872-9618
Tax Map No. section 35.00 block 6 lot 8.000
Cross Street MARINE PLACE
Issue Date: 11/27/02 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
• OFFICE OF THE TOWN CLERK C.OFO .. f'
ETHANE IOUTH WN CLERK �O CO - Application No. `7��
LI G $10.00 Residential
P.O.BOX 1179ir
SOUTHOLD,NEW YORK 11971
$25.00 - Non-Residential
Telephone . 2j `�����'
(516) 765-1801
TOWN OF SOUTHOLD RECEIVED
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
NOV 26
APPLICATION Clerk
Scomi3s L yQ
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. o?6we
Fee $
DATE / —a -6-
OWNER
OWNER NAME: ,�rj / Dl. / ,f01//7
OWNER MAILING ADDRESS: /0 kph,
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OWNER PROPERTY ADDRESS: ! / f S/74i /T2 r,O-JZef
OWNER TELEPHONE NUMBER:
TAX MAP NO. : Section 35-- Block Lot 612. OOG
CROSS STREET: i4i/IQ i/&'C.Q_
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool 1/ New V" Existing
Residential V 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 buil.ing and closest road.)
A
rSig Ore of App icant
RECEIVED BY:
Town Clerk's Office
DATE:
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r 0 Unauthorized alteration or addition to this
44, Q Nen York Mate Education Ian.
ifs � Copies of this survey map not bearing the
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not considered 10 he a true valid copy.
Distances shown front property lines to r
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P Certification indicated hereon shall run o
= M AFZ 11-4E_ P LACE prepared and on his behalf.to the Comps
assignees of the lending institution.t.'crti
institutions or subsequent owners.