HomeMy WebLinkAboutPiscitelli e,,,...�
JUDITH T.TERRY :' WA z=4
Town Hall, 53095 Main Road
TOWN CLERK ,.11
, P.O. Box 1179
REGISTRAR OF VITAL STATISTICS `t:°'� Qm�����$ Southold,New York 11971
MARRIAGE OFFICER ® Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER ,i' 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. 3689-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner PISCITELLI, DOMINIC AND
Mailing Address 1 UX, MABEL
Mailing Address 2 P. O. BOX 665
City St Zip MATTITUCK NY 11952-0000
Property Address 1 400 CARDINAL DRIVE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-8526
Tax Map No. section 115.00 block 4 lot 19.000
Cross Street MAIN ROAD
Issue Date: 9/17/97 Judith . Terry
• Southold wn Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK C,��FO(.,Ur�'-
Town of Southold CQG_ Application No.
Judith T. Terry, Town Clerk �` ,.r
Town Hail, 53095 Main Road a $10.00 - Residential•
P
O. Box 1179 cry
�� $25.00 - Non-Residential���: � •
Southold, New York 11971 O." .e';•
Telephone 74 $•
(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:•ot'M( +SIL � rst° ,ELS! /tirl� /) /i L_ U?C
OWNER MAILING ADDRESS:PO. 43)C 66s- �Ai r 17aC� ; R1Y llgsx
OWNER PROPERTY ADDRESS : 17400 1, AQb J 2 h i i a Cil ft.)/ --
OWNER TELEPHONE NUMBER• . 76 , 19k'- 6
TAX MAP NO. : Section / 1< Block T Lot / /
CROSS STREET: /0 A r Ili
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool t� New Existing F X (Sr,
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.)
i ��GsLL �
Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
J SC e A-77 A-0 e g'7A-Tro4 e-Ari g Si<3.a ek./j
S C 2� /1-7-! bFc`® Po-kf��{C2!y C CI'� tie-7
t i
r
,
MAI ll - ROAD
I
`s
��, 00,
.6 ®,
W w
-0 O , >
iiiO Cr
o N Q
en
-2_8
-J
Q
Lot 57 °o \`
, co— I
Ct
267. 861 mia z ; Cr
N.88°.88° 0' 6011E . U
sikn
O � 32 G.
u
�J `� , p \
�( `w U
O q SS oO" 0 1 `• /a33_^-___ 593 'r, \r
,, , ®��II ; 1—iv O
�'
Lot 56
-14I i o p_ i ®� IO
O o. C ¢,
4-1
O (4• 1
w \tia
r i o 1'" n i��11 O�_ ko
CO
4 S. 88° 24' 40i1 W.
287. 021
g"`
Lot 55
. i
SURVEY FOR ,
DOMINIC PISCITELLI
LOT NO. 56
"MATTITUCK ESTATES, INC. "
MATTITUCK GUARANTEED TO:
TOWN OF SOUTHOLD THE TITLE GUARANTEE
COMPANY
®
SUFF. CO., N .Y.
NOTE: SCALE . I" = 50° ,
® . MONUMENT DEC. I I , 1965 %✓�'z�
MAP OF SUBDIVISION FILED IN THE OFFICE, PROFESi10 " . 'NGINr,- - AND •1
OF THE CLERK OF SUFF. CO:;ION !SEPT.8,1085: I LAND SURVEYOR,N.Y. LIC. NO.12845 ;
AS MAP NO. 4453 ' ' , f''' ' ' RIVERHEAD, N.Y. i