HomeMy WebLinkAboutFrancia OFFICE OF THE TOWN CLERK 0111f �
Town of Southold � n•Ulj
Judith T. Terry, Town Clerk44 ._
Town Hall, 53095 Main Road
o _�,.. -� ,•;� tri
P. O. Box 1179 �u1 ;.• � „
Southold, New York 11971 °'' -,sai
Telephone - _�( !°
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 533 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool X
NAME OF OWNER: Frank P. Francia and wife
OWNER MAILING ADDRESS: Box 394
Southold, New York 11971
OWNER PROPERTY ADDRESS: 920 Cedar Point Drive East
Southold, New York
OWNER TELEPHONE NUMBER: 516-765-3162
TAX MAP NO. : Section 90 Block 2 Lot 19
CROSS STREET: Lakeside Drive
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New X Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: 1986
Judith T. T', ry
Southold Town Clerk
DATE: December. 14, 1987 i r 1
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(TOWN SEAL
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OFFICE OF THE TOWN CLERKFOur,�Q-
Town of Southold �® Application Not. --3-3
Judith T. Terry, Town Clerk . �b
Town Hall, 53095 Main Road �-:� -
`'• r4 } Residential
�
P. O. Box 1179 �' , r= C: Non-Residential
Southold, New York 11971 O - •
Telephone _ 1
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL .
Operation Permit No. 3
Fee $ 1 b IP
DATE /2/07
OWNER NAME: /90€ /W .reieAfk iie,fri/e i
OWNER MAILING ADDRESS: ,00G)( 31#
ezezeoeoe ,/,7/
OWNER PROPERTY ADDRESS: 720 ef.-14.4.--/$11Pti�
?7.7//77/
OWNER TELEPHONE NUMBER: ,576"--47‘.r-34e
TAX MAP NO. : Section 90 Block 2 Lot /7
CROSS STREET: /j/o/✓*
TYPE OF SYSTEM: Septic Tank / New Existing k�
Cesspool Kew / Existing /
' Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: 50,407 e/�I€ / 3F
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.)
Signature Of—Applicant
RECEIVED BY:
Town (Clerk's fice
RECEIVED
DATE: DEC 141987
Town Clerk Southold
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