Loading...
HomeMy WebLinkAboutMastropolo le"i. JUDITH T.TERRA' � 1.# $� Town Hall, 53095 Main Road TOWN CLERK ; eta " P.O. Box 1179 0 1 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS ® s Fax(516) 765-1823 MARRIAGE OFFICER ®�ie RECORDS MANAGEMENT OFFICER '_ 4j ` 11i' Telephone(516) 765-1800 FREEDOM OF INFORMATION OFFICER . 'a OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 3678-R Residential X Non-Residential Fee $ 10.00 New Existing X Name Of Owner MASTROPOLO, MICHAEL AND JEAN Mailing Address 1 P. O. BOX 616 Mailing Address 2 City St Zip LAUREL NY 11948-0000 Property Address 1 2828 PECONIC BAY BLVD. Property Address 2 City St Zip LAUREL NY 11948-0000 Owner Telephone No. 516-298-8749 Tax Map No. section 128.00 block 6 lot 22.000 Cross Street WENDY DRIVE Issue Date: 9/04/97 Judith T. Terry Southold Town Clerk (TOWN SEAL) • OFZ--ICE OF THE TOWN CLERK• -. Town of Southold Application No.(-- 7c5Judith T. Terry, Town Clerk �� �`{. ;x;. J► Town Hall, 53095 Main Road $10.00 - Residential P. O. Box 1179 $25.00 - Non-Residential Southold, New York 11971 Obi �'} �`� Telephone •• `j►� (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICAT ION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ DATE g— /3 _ p'? OWNER NAME: M ICARe'L, 01 A ST( oro Lo OWNER MAILING ADDRESS: /00 r3o),. 6 1 6 Lougee. ,,f, Y 1 ( 9 (rg OWNER PROPERTY ADDRESS: , 'vg-'$ f c.c (tc 13 ,9}'( I3 Li/0 LALi1et /4 Y 1,19 E OWNER TELEPHONE NUMBER: v9 $— g? (-0 TAX MAP NO. : Section y-7 32s8 ? Block ('Y$, Lot c CROSS STREET: Jt (p '' ® R I ✓E TYPE OF SYSTEM: Septic Tank New Existing Cesspool X New Existing X Residential X 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.) G Signature of App ' .nt RECEIVED BY: Town Clerk's Office DATE: -� ,sz-v.. . 3 +D \� 91 -, ..,„.,...---<";\ 1 I. . \ \ 9 , 91•A9- • 0 4 w o Sop s 46' 1 o \ 9a• rn �te5 t4.65 ...1 _ -,i,r :•irvavr \ —9'y /® S'_yi 181'iwl Cr _.: C� �Y{` V _...valid trU,copy. 1� � 9a a9a �e - \ \ , r-.tees indica d hereof.t • :ria•,mon •r wh:an t' N \ r3'i.aria on s:el,:." .,4i r , .-3ny, 8avorn alb:.�� N \ •+n.nn lir•, •b c� c,. \ Q �, t'-^9%4' �DJ5 LA :fl U•. o Cr - s} \` s,,. "\ m \ ` \ S \ ��oa�s �� r, O \,•, \46 ic ti 7.- \ i ts% \ a`� a _s,•\ , , 0 .* N \ r/ N. \ a ' L-2... %).. 4"6- (\ kr4 \.,- "' 1 55 \ 4., ,,y ... '' \ r \ .'' V\VI ' "C` ' • ' . ' q-- tylb‘? :. Fi. ' A/ e ...... ? 0, s� II:OA U',. f,1b .. .. '>'_ ,gyp -. .. J i-b i17 c: Tit /e �i r)�it`•l�C� �1r`+irJt�r1 14111,) , ,; c da , 7it/e !nsarayerc:e Ihi �11i���I, r L • , , .,0 ,�`z 'S r Dece ,fhEY 9, k� ? 7 . - ,� I. r"Y L, r'). t,. 0. ,,3—N,=-;-;.,. • ,- 91 � i.� Yd SUryei O S �� i %Vivi: N. Y. \ ' r '• 41 0 (J� :,. , rt,o �s l is c- L (5'.` !!,J 14.T ij r 0t f'xl.1.l - ,3(i.K4•+E. ;fr �, 1 r tom, .7_1Z-..1 d