HomeMy WebLinkAboutPagano N
V .
JUDITH T.TERRY o Town Hall, 53095 Main Road
TOWN CLERK c g P.O.Box 1179
REGISTRAR OF VITAL STATISTICS t‘ Southold,New York 11971
MARRIAGE OFFICER � .� �� Fax(516)765-1823 •
RECORDS MANAGEMENT OFFICER : �QLE3 �i ,,p Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 152-N Residential Non-Residential X
Fee $ 25.00 New Existing X
Name Of Owner PAGANO, JOSEPH
Mailing Address 1 PAGANO PIZZA
Mailing Address 2 P. O. BOX 1730
City St Zip SOUTHOLD NY 11971-0000
Property Address 1 MAIN ROAD
Property Address 2
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 516-765-6109
Tax Map No. section- 61 .00 block 1 lot 15.002
Cross Street YOUNG'S AVENUE
Issue Date: 4/27/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
II pi'R ►5
OFFICE OF THE TOWN CLERK S\\fFD(,(� �`
Town of Southold �� C'QG;� Application No. L t /
Judith T. Terry, Town Clerk �` ,: a y: /
Town Hall, 53095 Main Road a $10.00 - Residential
P. O. Box 1179 cn :, . i `' $25.00 - Non-Residential
Southold, New York 11971 O *$
Telephone I * l��`'e
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE /48/d !1 / fi.)
----
r i
OWNER NAME: jixTp --)i-A,. Q 4/`?)
OWNER MAILING ADDRESS: e� ` 9� 03/7
St;6,-144fii /t 4, 1/i2 /
OWNER PROPERTY ADDRESS: 1 ,41,4/ 2J 6.--064-)Lad (-5-34/73--
OWNER
$-3 /,5--
OWNER TELEPHONE NUMBER: )6S----6/ 9
TAX MAP NO. : Section 6 / Block 7 Lot /5
CROSS STREET: ya,/,t/f51 fr// ._
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential Non-Residential CV
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.)
5% nature o Applicant
RECEIVED BY: /
ALL.,,,,,,
Town Clerk's ffice
DATE: 4471671/ 5---
.
J d/
V
?)4(6)(1:9
rS I .
da
af-T'
cag-4
V