HomeMy WebLinkAboutMazzaferro JUDITH T. TERRY z Z ` Town Hall, 53095 Main Road
TOWN CLERK G T P.O. Box 1179-
REGISTRAR OF VITAL STATISTICS tri Southold, New York 11971
MARRIAGE OFFICER ® O� � Fax (516) 765-1823
Telephone (516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 2068-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner MAZZAFERRO, EUGENE
Mailing Address 1 804 8TH STREET -
Mailing Address 2
City St Zip GREENPORT NY 11944-0000
Property Address 1 804 8TH STREET
Property Address 2
City St Zip GREENPORT NY 11944-0000
Owner Telephone No. 516-477-2467
Tax Map No. section 48.00 block 1 lot 44.002
Cross Street CORWIN STREET
Date Of Last Pump Out 0/00/00
Issue Date: 3/05/93 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK cvFFOU(�'=
Town of Southold , CQ ; Application No. C)?/66,e/
Judith T. Terry, Town Clerk qi'
Town Hall, 53095 Main Road c , -
.t $10.00 - Residenti'al
P. O. Box 1179 cn "; ' r-ry ; $25.00 - Non-Residential
Southold, New York 11971
Telephone -_01 % • e
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
tor -
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE 2 ` D- ®53
OWNER NAME: 5evk_Q. - kzZ5''c `�cv. pZO
OWNER MAILING ADDRESS: UR <rn
OWNER PROPERTY ADDRESS: -- er
OWNER TELEPHONE NUMBER: 447-1-1 — ,-Ld B
TAX MAP NO. : Section Block Lot LI Li- 2.
CROSS STREET: C0�1.4-'
.- TYPE OF SYSTEM: Septic Tank - - NewExisting
Cesspool �' New_ Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: a�GC , /5-
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.)
, 064e,Ftow'
4.6-> 109 W00 �� ,0
IeRRM-
ignature of Applicant---
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RECEIVED BY: ,
Town Clerk's Office
DATE: