HomeMy WebLinkAboutMercorella 03011 -
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r t' Town Hall 53095 Main Road
�® O �.;�1� P.O. Box 1179
474®� �, ��'`i! Southold, New York 11971
JUDITH T.TERRY =�?..�rsr/i�'�'� 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. 1476-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner MERCORELLA,- ANTHONY J. & MARIA
Mailing Address 1 131 DUXBURY ROAD
Mailing Address 2
City St Zip PURCHASE NY 10577-0000
Property Address 1 2260 PECONIC BAY BLVD.
Property Address 2
City St Zip LAUREL NY 11948-0000
Owner Telephone No. 516-298-4815
Tax Map No. section 145.00 block 4 lot 4.000
Cross Street EDGEMERE AVENUE
Date Of Last Pump Out 0/00/00
Issue Date: 6/04/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK
%cOFO(,- '' 1
Town of Southold . C'' Application No. /9%
Judith T. Terry, Town Clerk $10.00 - Residential
Town Hall, 53095 Main Road -
P. O. Box 1179 tri V.4 hi . $
25.00 - Non-Residential
Southold, New York 11971 O ' ?" •`'
-=' -,.-=.. Off- •'
Telephone 0 �� •�
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE .6-42/90
T
OWNER NAME: 4-71/77.414/y tr, t-49-e-;/)- 4'7 7200,.6 L L,4•
OWNER MAILING ADDRESS: / 3 / C ax ex�2 y /f 4Lp
(( s E y. /0J-17
OWNER PROPERTY ADDRESS: , � C�-,02P4T ,e-CO t/'C
� L iv. y- �('q
OWNER TELEPHONE NUMBER:
t a V
TAX MAP NO. : Section ;/ S Block 4 5oLot
CROSS STREET:
TYPE OF SYSTEM: Septic -Tank New Existing
Cesspool ✓ New Existing
Residential ✓ Non-Residential
DATE OF PREVIOUS PUMP-OUT: t)
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.)
Signatur: c1,7 Applicant
RECEIVED BY:
own Clerk's Office
DATE: JUN 0413fiU
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V`' "f -• ' SURVEY FOR
• . ;,''L_ JOSEPH L. O'ROURKEp-s1-;
.y::4 :'..jt LAUREL *
Yom ', � ` :. ,�S��
GUARANTEED TO: ,
r` 5 kri TOWN OF SOUTHOLO ,
' s ' ° SUFFOLK COUNTY, N.Y. _ _'+ ,
'_:•-,'` ",''° '_ HOME TITLE DIVISION.CHI Ol `-
1 gi g- , ' SCALE I, =,301
TITLE INSURANCE`COMPA �'�'ry
'��r I,, t5, }.'4•_ APRIL 22,1968 JOSEPH L.O'NOVRKE. ..
ii A;4-4I•94 .
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