HomeMy WebLinkAboutVaccariello • 4 • - •
OFFICE OF THE TOWN CLERK ic.0fgUre
Town of Southold �� -
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Judith T. Terry, Town Clerk „_` r.
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 11971 ti O'hf `' 0`c-
Telephone „ v../ �� 0
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 210 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool x
NAME OF OWNER: Charles Vaccariello
OWNER MAILING ADDRESS: 300 Oakwood Drive
- Southold, New York 11971
OWNER PROPERTY ADDRESS: 300 Oakwood Drive
Southold, New Ybrk
OWNER TELEPHONE NUMBER: 516-765-1104
TAX MAP NO. : Section 70 Block 12 Lot 20
CROSS STREET: Pine Neck Road
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing x
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: October 1985
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Judith T. Terr
Southold Town Clerk
DATE: February 3, 1987
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK COMA-
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Town of Southold �QG', Application No.�/2
Judith T. Terry, Town Clerk �`� r
Town Hall, 1 -< Residential
53095 Main Road a � ����.P. O. Box 1179 = : v �.` Non-Residential
Southold, New York 11971 O - "s I
Telephone _ .(
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.c 2//
Fee $ {•�
DATE 9e't
OWNER NAME:
OWNER MAILING ADDRESS: 922 �/i�� /227 i)
cA.i-7 )?,4` Y /(97 7
OWNER PROPERTY ADDRESS:
OWNER TELEPHONE NUMBER: 7%f /712 £J"
TAX MAP NO. : Section 10 Block / Lot Cay,`
CROSS STREET: axce- P4
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential � Non-Residential
DATE OF PREVIOUS PUMP-OUT:
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.)
119Z/
Signatu/r& of ant
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RECEIVED BY: 47-z_c_2 a
MERIT C rk's Of ice
DATE: FEB OVC87
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Town Clerk Southold
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