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HomeMy WebLinkAboutNittoli ill,,,,I�##._ ,,,00��Ygin �oG ` :En ` ; Town Hall, 53095 Main Road ‘0,&_ *.,�$ P.O. Box 1179 Southold, New York 11971 JUDITH T. TERRY 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. 1085-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New Existing X Name Of Owner NITTOLI, MARGARET H. Mailing Address 1 2130 PLUM ISLAND LANE Mailing Address 2 City St Zip ORIENT NY 11957-0000 Property Address 1 2130 PLUM ISLAND LANE Property Address' 2 City St Zip ORIENT NY 11957-0000 Owner Telephone No. 516-323-2649 Tax Map No. section 15.00 block 5 lot 30.000 Cross Street RYDER FARM LANE Date Of Last Pump Out 0/00/00 Issue Date: 4/18/89 Judith T. Terry Southold Town Clerk (TOWN SEAL) • • OFFICE OF THE TOWN CLERK �S�FF�U,C'0- Town of Southold , 0��}f Application No. D Judith T. Terry, Town Clerk . Town Hall, 53095 Main Road ';" :< Residential P. O. Box 1179 v' ;e': tr'1* n ; 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 $ / D • DATE 7gf�/s)� OWNER NAME: /`J g x /4 A)ITO OWNER MAILING ADDRESS: 2 /30 I 11,1 / .§) 4, O'c � � ,�,. // rc37 OWNER PROPERTY ADDRESS: /9-7)2F- OWNER TELEPHONE NUMBER: 3—,a3 — 6 a TAX MAP NO. : Section Block Lot o CROSS STREET: /' ! lj E2_. [ i''! ACZEPP. TYPE OF SYSTEM: Septic Tank New Existing Cesspool 1,7 New Existing 1-7 Residential V Non-Residential DATE OF PREVIOUS PUMP-OUT: /V O ILYE- 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.) ie.nature of Applicant RECEIVED BY: Town Clerk's Office DATE: Atter..co. VB e'r. 60•n w{i ALT it: gegvi«Sa ' -'11-1,7,-.! - �`. 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