HomeMy WebLinkAboutMagagnin 111/1/l1 ��
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1' Town Hall, 53095 Main Road
&ft44 P.O. Box 1179
`- Southold, New York 11971
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® *'i! ��� FAX(516)765-1823
JUDITH T.TERRY /i�'" TELEPHONE(516)765-1801
TOWN CLERK
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 958-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner MAGAGN I N, JOSEPH
Mailing Address 1 535 BAY HOME ROAD
Mailing Address 2
City St Zip SOUTHOLD NY 11971-0000
Property Address 1 535 BAY HOME
Property Address 2
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 516-765-1233
Tax Map No. section 56.00 block 5 lot 23.000
Cross Street WILLOW POINT ROAD
Date Of Last Pump Out 0/00/00
Issue Date: 12/19/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK c,31FO(,r0'=
Town of, Southold �� CQ Application No. (�1�
Judith T. Terry, Town Clerk �` ;- w -.
Town Hall, 53095 Main Road a a' -4 I Residential
P. O. Box 1179 ; `-_ .iv-:_.-a•. ` ,, Non-Residential
Southold, New York 11971 O $`
Telephone__ _ "'- t�.':_- _-�l' 40-/'
;.-_ (516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE 11--► r' tg r3
OWNER NAME: J t,P 5 E r!4 tsetA en A 41--) 1 tJ
OWNER MAILING ADDRESS: 5 3 5 'BAT 1+01 t E" 12. 1)
51:20114oLD N `( 1111 /
OWNER PROPERTY ADDRESS: SAtot 6'
OWNER TELEPHONE NUMBER: 51. 4- 74, S - 0- 33
j TAX MAP NO. : Section 6 (o Block Cj Lot 2--2-)
CROSS STREET: w IL.Le.,..) /;70„_n-- r2-9
TYPE OF SYSTEM: Septic Tank e.- New - Existing i-------
Cesspool
-Cesspool New Existing
'Residential v'' Non-Residential
DATE OF PREVIOUS PUMP-OUT: Iccr 7
LOCATION MAP: Must be attached heretobefore permit may be issued. .
(Locate building and system; give north arrow and feet
of distance, approximately, to building and, closest road.)
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