HomeMy WebLinkAboutPrato J
4P-If air ,
it M Town Hall, 53095 Main Road
�� �® � 1� P.O. Box 1179
����� Southold, New York 11971
JUDITH T.TERRY 111 ® � TELEPHONE
TOWN CLERK `����_•
(516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3561-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner PRATO, SALVATORE
Mailing Address 1 580 WIGGINS LANE
Mailing Address 2
City St Zip GREENPORT NY 11944-0000
Property Address 1 580 WIGGINS LANE
Property Address 2
City St Zip GREENPORT NY 1191 -0000
Owner Telephone No. 516-477-2295
Tax Map No. section 35.00 block 4 lot 28.030
Cross Street NORTH ROAD
Issue Date: 12/10/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK c31FDU( "-
Town of Southold � 4 .:� Application No--5 /
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road ! $10.00 - Residential
P. O. Box 1179 $25.00 - 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'
Operation Permit No.
Fee $ 49 • 441)
DATE e '/$ C
OWNER NAME: S/7-i1/i 71/2L`r ,0i f
OWNER MAILING ADDRESS: 5-8 //6 -/A/s-
Oma:axe v, /O.Y /1Q
OWNER PROPERTY ADDRESS-: - -
5�-t�r
OWNER TELEPHONE NUMBER: 4/77-2-2-67C—
V7389 ? 3 � r / -' zO 33
TAX MAP NO. : Section Block Lot
CROSS STREET: 4/Qn77/ l
TYPE OF SYSTEM: Septic Tank ,x New Existing
Cesspool x New Existing x
Residential_7X 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.)
Signatu e of Applicant
ECEIVED BY:
- - Town Clerks Office _.
•
DATE:
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UNAUTHORIZED AL1ERAt10N OR ADDITION
TO THIS SURVEY IS A VIOLATION OF
SECTION 7109 CF THE NEW YORK STATE
EDUCATION LAW,
` COPIES OF THIS SURVEY MAP NOT BEARBNQ
11�_ c UTE LAID U;V
S FYOR'S INKED SEAL OR
S t7g�t EM8O5SED SLAL SHALL NOT BE CONSIDER
r— ���� D��O1t60 bi. TO BEA VALID FLUE COPY.
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--- �iA GUARANTEES INDICTED HERON SHALL QLltt
LOT L1 U6 AS ML6a M,L p, — ONLY i0 THE?E SON FOR YJHOM THE SURVA
���u ��'' ` //// IS PREPARED,AND ON HIS BEHALF TO THE _
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-.v•., ING OF THEON ELENp NG INSTID HiPEON,, D
DA i�Q�.. ® ms =QO LI 21 f 6 TUTEON.GUARANTEES ARE NOT TRANSFERABLE
TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT
OWNERS.
TTL L LC 07 - 82199 ' eYvAeAUTL6b TO Ocrun4oLD savctHCs "mNII-
4144 Maiwzi4A1! '(TYLE 1146U2Aut6 compAuy
Id OT A3 6Uuvsy6t) ; Aug. 27, 11
LCA 1;�!�1Br '� :.-, ",71.1, Q6CE Ta II &Ann o� t10t� t$1C6( V4 T y i P. C.
FOoLLI U Ac2,6S -56C j icl ,V3,ll7 FILED !h! TU6 "i�- , 1(a.�--ri2
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