HomeMy WebLinkAboutGazza JUDITH T.TERRY �0 •
Town Hall,53095 Main Road
TOWN CLERK t • P.O.Box 1179
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REGISTRAR OF VITAL STATISTICS ` Southold,New York 11971
MARRIAGE OFFICER �f% ��'�� Fax(516)765-1823
RECORDS MANAGEMENT OFFICER ,,ell 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. 3301-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner GAZZA, ROBERT AND DIANE
Mailing Address 1 2850 CEDAR BEACH ROAD
Mailing Address 2
City St Zip SOUTHOLD NY 11971-0000
Property Address 1 2850 CEDAR BEACH ROAD
Property Address 2
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 516-765-1471
Tax Map No. section 91 .00 block 1 lot 3.002
Cross Street PARADISE POINT ROAD
Issue Date: 1/11/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK �C3IFO(,r`;-
Town of Southold 4% Application No.cT36
Judith T. Terry, Town Clerk �` *.4:\
Town Hall, 53095 Main Road < $10.00 - Residential l�
P. 0. Box 1179 cn ' `' $25.00 - Non-Residential
Southold, New York 11971 O /
Telephone 70j * ��0$�
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ 16
DATE9A-""42-- Ff
OWNER NAME: 72.0 6Z2Z-9` \f- �2-��--
OWNER MAILING ADDRESS: Z) 7/d"f2- 95 a 14-
cri-t"ivirT7-19 •)/t (77
OWNER PROPERTY ADDRESS: - 6(
OWNER TELEPHONE NUMBER: -XS= l 1` 77
TAX MAP NO. : Section ( Block ( Lot
CROSS STREET: ill 995 Pa l JIT
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential sV Non-Residential
49 SLY -'7977 c 77/1"-- LAMS Pci -P2 d(.4 7--frivp
LOCATION MAP: Must be attached hereto before permit may be issued. C-i--- /67.)
(Locate building and system; give north arrow and feet
of distance, approximately, to building -and closest road.)
ignature of AA .licant
RECEIVED BY:
Q own Clerk's Office 7 3 s
DATE:
AN 1 1 1995
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