HomeMy WebLinkAboutVardaro eleoFF00,
Hall,Town ELIZABETH A.NEVILLE T
A. may C06:
; 53095 Main Road
TOWN CLERK ® ¢ P.O. Box 1179
% C Southold,New York 11971
REGISTRAR OF VITAL STATISTICS �'�� Fax(516) 765-1823
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER ` ®� ��®���,' Telephone(516) 765-1800
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FREEDOM OF INFORMATION OFFICER = •�1,
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3835-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner VARDARO, PASQUALE AND SANDRA
Mailing Address 1 58 CONKLIN AVENUE
Mailing Address 2
City St Zip WOODMERE NY 11598-0000
Property Address 1 365 MARINE PLACE
Property Address 2
City St Zip GREENPORT NY 11944-0000
Owner Telephone No. 516-477-0511
Tax Map No. section 35.00 block 6 lot 10.000
Cross Street SNUG HARBOR ROAD
Issue Date: 12/02/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK �S\\FFU(,�
Town of Southold �� CQ Application No.g..57, 5-
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road - $10.00 - Residential
P. O. Box 1179 u' :n`' ' i $25.00 - Non-Residential
Southold, New York 11971 O
Telephone
g.
(516) 765-1801 '
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
•
Fee $ •
DATE 1Z - Z -�
OWNER NAME: /NS ottc_rz-
OWNER MAILING ADDRESS: S¶ ( 1 h•--S /\-1/4.) P
oc)--(vve (Le Y /I .5-7'
OWNER PROPERTY ADDRESS: i\A
C—z n.s pow 7— A/(i /71 c1 -_
OWNER TELEPHONE NUMBER: 3R-{ 6 f
TAX MAP NO. : Section 3c--- Block Lot / O
CROSS STREET: �� U(.74`q���� e
TYPE OF SYSTEM: Septic Tank New ' Existing
Cesspool New Existing
Residential // Non-Residential
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 Applic t
I UU
RECEIVED BY: P'til
Town Clerk's Office
DATE: /
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SURVEY NO. 7J'532