HomeMy WebLinkAboutTroccoli (2) OFFICE OF THE TOWN CLERK %')
Judith
- Town of Southold
Judith T. Terry, Town Clerk ,G !
Town Ha LI, 53095 Main Road
P. O. Box 1179
Southold, New York 1.1971
Telephone -WO1'
(516) 765-1801 •
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 431 Residential X
Non-Residential '
Fee $ 10.00 • Septic Cesspool X
NAME OF OWNER: Robert Troccoli
OWNER MAILING ADDRESS: 710 Jockey Creek Drive
Southold, New York 11971
OWNER PROPERTY ADDRESS: 4370 North Bayview-Road
Southold, New York
OWNER TELEPHONE NUMBER: 516-765-3095
TAX MAP NO. : Section 79 Block 2 Lot 4.3
CROSS STREET: Ships Lane
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X . New X Existing
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: New System
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DATE:
DATE: September 18, 1987
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(TOWN \SEAL)
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' OFFICE OF THE TOWN CLERK C.
Town of Southold %..), air l Application No. 4/31
Judith T. Terry, Town Clerk .` -. •' )
Town Hall, 53095 Main Road :� I Residential
P. O. Box 1179 En `. fi" z' Non-Residential
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Southold, New York 11971 O # r ��`�
Telephone ei 4 �.�0
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(516) 765-1801 -
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ %d
DATE
•
OWNER NAME: 1 O 661?--71 717 e 11
OWNER MAILING ADDRESS: '110 Jockey G1
SaU7-1•1a ?-7J
OWNER PROPERTY ADDRESS: ,644 yl4>teea feZ (132,61)
5 d-a -r'l/v („-D toy, /o $1'-7
OWNER TELEPHONE NUMBER: ) a %�
TAX MAP NO. : Section ) Block Lot 74. 3
CROSS STREET: 511//5Nr
TYPE OF SYSTEM: Septic Tank /d-19 New ✓ Existing
Cesspool 3 - x 1lew Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT:
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LOCATION MAP: Must be attached hereto before permit may be issued.
(Locate building and system; give north arrow and feet
of distance, approximately, to building and closest road.)
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Signal! re of Applicant
RECEIVED BY: - -
agovc9wn Jerk's fice
DATE: SEP 17 V
Ton CIA So i'910
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( NORTH fEIN RD. ,° ,-, 3 '
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0BAYVIW)MAP OF JAMES W. DAWSONFILE16, 1985
FILE NO . 7987
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I3's ( DWELLING ) 20.63 CERTIFIED TO :
N / 0/ F CHERYL ANN MC CABE , FIRST AMERICAN TITLE INSURANCE
COMPANY OF NEW YORK
I a BARRY H. HE L L M A N SOUTHOLD SAVINGS BANK
f� i ,-�,.\j R OBE R T TROCCOLI
�,�` "" PV o JANET TROCCOLI
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P 49 ?,' :• ELEVATIONS ARE REFERENCED standards fae title sureey$ as establl�hed by
.� ,. tlo TO AN ASSUMED DATUM. ;he L.1.A.L.S. and appra`/ed and ad°Pte
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