HomeMy WebLinkAboutSopkia -
oilicOf Wire^
JUDITH T. TERRY
• Town Hall, 53095 Main Road
TOWN CLERK 21C .' P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS `V �t' Fax (516) 765-1823
MARRIAGE OFFICER sj" ®, �� Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER i��clll
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3197-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner SOPKIA, MARILYN J.
Mailing Address 1 233 N. MOUNTAIN AVE.
Mailing Address 2
City St Zip MONTCLAIR NJ 07042-0000
Property Address 1 10595 PECONIC BAY BLVD.
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-293-4122
Tax Map No. section 144.00 block 3 lot 16.000
Cross Street MARLENE LANE
Issue Date: 5/19/94 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
1 '
OFFICE OF THE TOWN CLERK c��FFO(,(r��'
Town of Southold � CQG' Application No. .3/ t 7
Judith T. Terry, Town Clerk . "," y
�� � :4 ' $10.00 - Residential ✓
Town Hall, 53095 Main Road _ , �,,�
P. O. Box 1179 u' ,.` $25.00 - Non-Residential
Southold, New York 11971 O ® ��`
• Telephone 1490/ ����'�•
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
'AP-'Ll CAT iC
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.�y
Fee $ /0, D-0
DATE r; � ,2o
l/ y
OWNER NAME: 9 '/g�-/ l J . EThoe, �.
OWNER MAILING ADDRESS: 3 iv, /IA d4,, �,� c_
U` o - ]- CLI1 - � j . 07°(7 Z-
OWNER PROPERTY ADDRESS: /D_6- _ feG c r /3)Vc!,U irgl
Ma-4+4u c.%
1L l, // S/"`�- l�
OWNER TELEPHONE NUMBER: e2'-1// Z 2 j -2 / - 7v6- 4-7(76y
TAX MAP NO. : Section Block Lot
CROSS STREET: dri)GC.( 'ev2
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing /✓
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.)
he2,14,4,
Sig tur of Applicant
RECEIVED BY:
Town Clerk's Office
DATE: L}" dZ7_P‘-
C
. _
--- --- -
. ,
hor._(PladeifilAtc.
2-
_
0
/
e) -2 . 3 p . Ylitoc.4. Ail a ,,---) At-e.-
_ _
/ Al. — 7 C/--2--
. _ ___ .
_.
----! \ ___
.
4-)-
‘, \; ffb:f--
_ - - -
---7-->
17 s 06°4
wn- --
C)) : °t-/ ° ---=----- -..
- -
i _,..... ,
' q
;--..,.
1 \ /
___ _ — --------------
7),
1 -
3 - / _ . . _ . _ _ _ .
. , ..
II, .