HomeMy WebLinkAboutTufano ELIZABETH A.NEVILLE �y®� oGy� Town Hall, 53095 Main Road
TOWN CLERK ; o= !� P.O.Box 1179
t cn 2 Southold,New York 11971
REGISTRAR OF VITAL STATISTICS Fax Fax (516) 765-1823
MARRIAGE OFFICER 1- �a®�/�0 Telephone(516) 765-1800
RECORDS MANAGEMENT OFFICER y*
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3830-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner TUFANO, WILLIAM AND MILLICENT
Mailing Address 1 35 RYDER AVENUE
Mailing Address 2
City St Zip DIX HILLS NY 11746-0000
Property Address 1 2482 CAMP MINEOLA ROAD
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-586-0255
Tax Map No. section 122.00 block 9 lot 9.006
Cross Street KRAUSE ROAD
Issue Date: 11/27/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK COFD(,( .
TOWN OF SOUTHOLD &% , : COIj�_ Application No. �36.�0
ELIZABETH A.NEVIJ.I.F,TOWN CLERK A.,..:',.- $10.00 - Residential ,___---
P.O.BOX 1179 -
SOUTHOLD,NEWYORK 11971 • �����, $25.00 - Non-Residential
-• Telephone - ej 'No'.'
(516) 765-1801
TOWN OF SOUTHOLD
•
SOUTHOLD -WASTEWATER DISPOSAL DISTRICT
APPLICAT ION
- for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE 1///2— 7dr
•
OWNER NAME: M net -6 � ! I ` r c cea 7if,4, /O
OWNER MAILING ADDRESS: 3� p yJ Gn. j4E.
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OWNER PROPERTY ADDRESS: 21a2. o,v/ l!%xi c4 JP
ii T7-, e7, /t/Y, //9
OWNER TELEPHONE NUMBER:5g- a6- D2,Cr- a,93 7--19/2C
j TAX MAP NO. : Section /0207 do Block 9 Lot 9, (log
CROSS STREET: k.„---1.0-te-- ._ (2.--
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TYPE OF SYSTEM: Septic Tank New Existing X
Cesspool New Existing
Residential Non-Residential
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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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Signature of A,•.• cant
RECEIVED BY: - /./L
iown Clerk's office
DATE: / Z/
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