HomeMy WebLinkAboutFiume (2) • OFO/4C
ELIZABETH A.NEVILLE �,L�° ®4�; Town Hall, 53095 Main Road
TOWN CLERK4 ® P.O. Box 1179
2 Southold,New York 11971
REGISTRAR OF VITAL STATISTICS ° •
Fax Fax(516) 765-1823
MARRIAGE OFFICER ®���� Telephone(516) 765-1800
RECORDS MANAGEMENT OFFICER -:°�®I iii
FREEDOM OF INFORMATION OFFICER �°•
��,l
... .0'
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3801-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner FIUME, LAWRENCE
Mailing Address 1 7720 SOUNDVIEW AVENUE
Mailing Address 2
City St Zip SOUTHOLD NY 11971-0000
Property Address -1 7720 SOUNDVIEW AVENUE
Property Address 2
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 516-765-6120
Tax Map No. section 59.00 block 9 lot 15.000
Cross Street JAROZ
Issue Date: 7/21/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
-4
OFFICE OF THE TOWN CLERK CgFO(x
TOWN OF SOUTHOLD Off. CSG Application N0.
FTI7ABETH A.NEVIT.LF;TOWN CLERK $10.00 - Residentia I r
P.O.BOX 1179
Cs)
SOUTHOLD,NEW YORK 11971 $25.00 - Non-Residential
Telephone _el * •
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
- for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE
OWNER NAME: Lor0 ,Vliit, F=iw(til.iz
OWNER MAILING ADDRESS: '11-1 C) c Afu ) AAA
SCM v td i 1kckY\ k
-OWNER PROPERTY ADDRESS:
OWNER TELEPHONE NUMBER: r5-
TAX-MAP NO. : Section Block Lot I S
CROSS STREET: UlyC7.(privc- e_
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential ✓ Non-Reidential
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.)
I ,
Sig ature -(3'. pp'cant
RECEIVED BY: RECEIVED
Town Clerk's Office
DATE: JUL 2 f 1999 -
Southold Town C rlt