HomeMy WebLinkAboutStocco ® c;+VA
Town Hall, 53095 Main Road,
P.O. Box 1179
--%e $4 ,e. Southold, New York 11971
JUDITH T.TERRY FAX i!�� FAX(516)765-1823
��` TELEPHONE(516)765-1801
TOWN CLERK
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. 1357-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner STOCCO, ROSALIND
Mailing Address 1 2059 UNION BLVD.
Mailing Address 2
City St Zip BAYSHORE NY 11706-0000
Property Address 1 1425 SOUNDVIEW AVENUE
Property Address 2
City St Zip ORIENT NY 11957-0000
Owner Telephone No. 516-323-3596
Tax Map No. section 15.00 block 3 lot 16.000
Cross Street THREE WATERS LANE
Date Of Last Pump Out 0/00/00
Issue Date: 1/10/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK sc0Fg �'-
Town of Southold Application No.A__37
Judith T. Terry, Town Clerk 07 N
Town Hall, 53095 Main Road $10.00 - Residential
P. O. Box 1179 U' s, toff i • $25.00 - Non-Residential
Southold, New York 11971 O cts
Telephone41 `A�
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE /6//(0/97
/&
I s
OWNER NAME: 5 1L Q LCO O �G 1 j�� • •
OWNER MAILING ADDRESS: c.9, 0 S9 !/1 V-c
OWNER _PROPERTY ADDRESS- 3u,(\
7 0 -
OWNER TELEPHONE NUMBER: CS—Pa) 30 - G
TAX MAP NO. : Section / S Block Lot /(0
CROSS STREET: tr-pa2 1/4X)oci--e_N- Lan -Q.—
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool > New Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT:
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.)
Signature of Applicant
RECEIVED BY: /V/
Town Clerk's Office
DATE: // /9e9
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