HomeMy WebLinkAboutRizzo OFFICE OF THE TOWN CLERKFU
Town of Southold SVF �C�G
Judith T. Terry, Town Clerk Z
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Town Hall, 53095 Main Road
P. O. Box 1179 %i
Southold, New York 11971 _p stt���-�,;
Telephone _ �( t
(516) 765-1801 ''
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
• SEPTIC TANK' or CESSPOOL
Operation Permit No. 216 Residential X
Non-Residential •
Fee $ 10.00
Septic Cesspool X
NAME OF OWNER: Frank and JoAnn Rizzo
OWNER MAILING ADDRESS: 150 Maple Road
Southold, New York 11971
OWNER PROPERTY ADDRESS: 150 Maple Road
Southold, New York 11971
OWNER TELEPHONE NUMBER: 516-765-1858
TAX MAP NO. : Section 54 Block 9 Lot 20
CROSS STREET: Pine Road
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: 1984
Judith T. Terry
Southold Town Clerk
DATE: February 6, 1987
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK ••��FD ,
Town of Southold �o�.. COG Application No.02/4)
_
Judith T. Terry, Town Clerk �� .. ;"
Town Haft, 5305 Main Road
Residential
j
P. O. Box 1179CJ7 , : �. Non-Residential
Southold, New York 11971 O '® ^ ' �.`
Telephone = .( :
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operatio Permit Noe-- 1
Fee $ i'd
DATE `." v) /9 Y7
OWNER NAME: ji4pAti.) vp,a,e ay‘ )
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OWNER MAILING ADDRESS: /6-7)
21, )797)
OWNER PROPERTY ADDRESS: )/N7.,4V2-7
OWNER TELEPHONE NUMBER: 5 ) 4 - 76s-- /8SY
TAX MAP NO. : Section v�4 Block ,--59 Lot WavC2D
CROSS STREET:
TYPE OF SYSTEM: Septic Tank New Existing
Cesspoolv New Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: /7
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.)
Signatur7 Applicant
RECEIVED B _k 4,4 re
d��Czdvc� o n Clerk' Office
DATE: FEB 06 1997
Town Clerk Southold
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