HomeMy WebLinkAboutSwiatocha ,', rhsi;>r 1
-ate '%r�r�•k��,Rpy-
`_ .,, '' Town Hall, 53095 Main Road
``1 O ' 4®�i6It P.O. Box 1179
.ij sem, o,!' Southold, New York 11971
JUDITH T.TERRY `= %'`�� FAX(516)765-1823
TOWN CLERK TELEPHONE(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. 1486-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner SWIATOCKA, FRANK J. AND ANNE
Mailing Address 1 P. O. BOX 1051
Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
Property Address 1 465 HAMILTON AVENUE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-4022
Tax Map No. section 140.00 block 2 lot 3.000
Cross Street MARY'S ROAD
Date Of Last Pump Out 0/00/00
Issue Date: 6/18/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
\fir
OFFICE OF THE TOWN CLERK c0FO(,(C'
Town of Southold n OG Application No. / 47g.
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road $10.00 - Residential
P. O. Box 1179 cry { Vig $25.00 - Non-Residential
Southold, New York 11971 •�`�
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE TUNE l� 89n
OWNER NAME: FR/INK 37 ADD 17/ ,1/ir cIWI ATo
OWNER MAILING ADDRESS: r' Oe 8® ,y /06//,
1`' ,11476.2„_, )
OWNER PROPERTY ADDRESS: 6 ,j l4l1T 1/.7-8,6/ A Vc/V J i
/ 4-r7-1-7-14c Ic A'
OWNER TELEPHONE NUMBER: 67C-- q '- 4-1-002/.2„,
TAX MAP NO. : Section ,Tca Block Lot 3
CROSS STREET: /,4R'/S 'OMD
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool ✓ New Existing
Residential V Non-Residential
DATE OF PREVIOUS PUMP-OUT: 61-29/910
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.)(6>'
_'.nature of Applicant
RECEIVED Br: "+ei;• `f,�",,+*����
U LTbvwhU elem.s Office
DATE: a5 Eag
U
off,,,^ eg=
--;;;--1..., . I
s
i
.
.
- - ._... . - 101_-_ .. __ . .... - _- -.... _-. . _ - .. ..._ - -_ - - - -
•
• . - H SIJ
.
•
. C......' :
•
I
I '
1 . _
. .
, .
_ __ , __ __ ,
. ....
ep .
..
..
..
1- . - -I .., . . _ . Tii‘t - .... . _ -. - .----- ...... - _ - ,
.. 7---- 1, ,
..
I
::_ewremtlez
. .
. _ . . __ __. . ... ...._
fic-_-.16 ...,‘ 1,
i
S-1,.... , _
Hiz,), __ _ .. .
_
R� ii -
. ,M . ,.
i 4,2 b
_ __ _____ ___ ____ , ____, _ _.__
, Ari , - - - ....
I - - IC) a%1 1 / - - -- - _
‘Nytt .,
i
ot... ___ \
v <
-- --- - -- - -- -D i 1 'fie - -�,9 y - -- , - C-il A-ri.7-� -
- `
ii '- -
- - _ - - -- - - - - - - --
I
fL.* _ _ - - -_, - , - _ _ ,________;...._._ .________________,,.,.........j.. _ . .._ . _ '. ._ _ t.
-/E,I CI%18..) -41; vIO LcA
1
I
s m T