HomeMy WebLinkAboutScotto JUDITH T. TERRY Z Town Hall, 53095 Main Road
TOWN CLERK ® r P.O. Box 1179
t.fl Southold, New York 11971
REGISTRAR OF VITAL STATISTICS =VVA, ��� Fax (516) 765-1823
MARRIAGE OFFICER A, iO Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER _ ®l it
FREEDOM OF INFORMATION OFFICER i��l
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3268-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner SCOTTO, LOUIS AND SALLY
Mailing Address 1 2400 ALDRICH LANE
Mailing Address 2
City St Zip LAUREL NY 11948-0000
Property Address 1 2400 ALDRICH LANE
Property Address 2
City St Zip LAUREL NY 11948-0000
Owner Telephone No. 516-298-8934
Tax Map No. section 125.00 block 1 lot 2.023
Cross Street ROUTE 25 & SOUND AVENUE
Issue Date: 10/18/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK COMA'
Town of Southold �� c "::_\ Application No. 6cr---)
Judith T. Terry, Town Clerk .` r • •.-
Town Hall, 53095 Main Road $10.00 - Residential
P. O. Box 1179 v' , .'' i ;' $25.00 - Non-Residential
Southold, New York 11971 O `'o�r•�•�
Telephone Oj �e'a i1
41 0
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $/,()..0 )
DATE /0/17 J `! 5
OWNER NAME: ! p �� ) 1 - 6
OWNER MAILING ADDRESS: �134() 4 JtLjr-
t 9 . \•'
OWNER PROPERTY ADDRESS: °(i_
OWNER TELEPHONE NUMBER:
/ 53 .. 9 3 4.,
2
TAX MAP NO. : Section l� Block I••• 23
Lot- -
CROSS STREET: Rte, g_< mat A ac-
TYPE
sTYPE OF SYSTEM: Septic Tank / New Existing V
Cesspool New Existing 1/
Residential Non-Residential
LOCATION MAP: Must be attached hereto before permit may be issued.
(Locate building and system; give north arrow and feet
of distance, approximately, to building and closest road.)
Sign r- of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
74144 2, a 1--;:tie,e,c,4,s4._21 tf.c 'f'l
A
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$ k:;Ii ); H