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HomeMy WebLinkAboutMacari OFFICE OF THE TOWN CLERK • •c,,OFeU``+. Town of Southold � • �y A . Judith T. Terry, Town Clerk � Z _ r- Town Hall, 53095 Main Road ~ ' P. O. Box 1179cn `° _ ��•� Southold, New York 11971 \s---(10/�7 �O�-�• Telephone 0( i (516) 765-1801 - TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 613 Residential X" Non-Residential Fee $ 10.00 Septic Cesspool X_ NAME OF OWNER: Anthony L. Macari OWNER MAILING ADDRESS: 3120 Ole Jule Lane Mattituck, New York 11952 OWNER PROPERTY ADDRESS: 3120 Ole Jule Lane Mattituck, New York - OWNER TELEPHONE NUMBER: 516-298-5074 TAX MAP NO. : Section 122 Block 4 Lot 20.1 CROSS STREET: Kraus Road TYPE OF SYSTEM: Septic Tank New Existing Cesspool X New X Existing Residential X Non-Residential DATE OF PREVIOUS PUMP-OUT: Unknown -Judith T. Terry Southold Town Clerk DATE: February 16, T988 - • (TOWN SEAL) • OFFICE OF THE TOWN CLERK S\VFO(/,r Town of S9uthord 0o s ,,�G'_, Application No. Judith T. Terry, Town Clerk I Town Hall, 53095 Main Road cm C» { , Residential - p, O. Box 1179 M • ` Non-Residential Southold, New York 11971 _ {' �`� Telephone • (516) 765-1801 _ 1 RFCTIVED TOWN OF SOUTHOLD JAN 141987 SOUTHOLD WASTEWATER DISPOSAL DISTRICT 'intim Clerk Southold APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 6 a oy Fee $ / 0 r � DATE OWNER NAME: -�K © -y GICLe ds OWNER MAILING ADDRESS: it4-777 T -c-0-/ . OWNER PROPERTY ADDRESS: . OWNER TELEPHONE NUMBER: (576 ;1-4, Sb ? TAX MAP NO. : Section /AA, Block Lot J/j1 / CROSS STREET: TYPE OF SYSTEM: Septic Tank New Existing Cesspool t New 1/ Existing Residential C / Non-Residential DATE OF PREVIOUS PUMP-OUT: 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.) Srgnat re of Applicant RECEIVED BY: [At,- Town `fi'erk's 0 ice DATE: /6e /ed . r / (� / (-4 0 .4 C & (0,I