HomeMy WebLinkAboutVassallo ��-
1, - •"® FOL j®
ELIZABETH A.NEVILLE 1� y Gym; Town Hall, 53095 Main Road
TOWN CLERK c < P.O. Box 1179
ti 2 ; Southold,New York 11971
REGISTRAR OF VITAL STATISTICS ; . Fax (516) 765-1823
MARRIAGE OFFICER `4*/) ��®�'��� Telephone (516) 765-1800
NK1
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER = of-
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 3833-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner VASSALLO, SYLVESTER AND MARY
Mailing Address 1 66 HARVEST LANE
Mailing Address 2
City St Zip COMMACK NY 00000-0000
Property Address 1 1215 FARMVEU ROAD
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-499-4845
Tax Map No. section 121 .00 block 7 lot 8.000
Cross Street SOUND AVENUE
Issue Date: 11/27/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
10
OFFICE OF THE TOWN CLERK ���FOUr•'"
TOWN OF SOUTHOLD ��
, ,• lj Application No.
ELIZABETH A.NEVILLE,TOWN CLERK „4, ' "xW �l $10.00 - Residential
P.O.BOX 1179 • a t<c
SOIJTHOLD,NEW YORK 11971 *�® ,,ft' �•;� $25.00 - Non-Residential
• Telephone ''
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERA : I PERMIT
SEPTIC TAN or CESSPOOL
Operation Permit No.
Fee $ /0, 00
• DATE O C-T. 5#3 erg
OWNER NAME: 1,.1 cc &�.0 1 gYL-VE3Tef.. tri `”y
OWNER MAILING ADDRESS: 6 (42 vg-51 1. ild
COM frt fa-C,i( ray
OWNER PROPERTY ADDRESS: RI C FlierAVVIA ALL)
�►'9)9-7-r1"P tA cy. Ivy1 I ei;a.
OWNER TELEPHONE NUMBER: /9 - LICY
TAX MAP NO. : Section 1 ?-) Block `7 Lot g
CROSS STREET: Sc I) VEauE
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool I/ New Existing
Residential a/ 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.)
ar=„c
Signature of Applicant
RECEIVED- BY:
Town Clerk's Office
DATE: 0 /3- 7/
O
w
w000:", S 80.06,50„ E
+ 0+liV.
O' Cod
�o b V /
�/ cEsspooL__;.,._,,,
` 3I
RI
... \ 4„--r.„1.-
\ /
•
,1\
\ ���T ,��a ''�/ Alb
Pa
'
ww`/t� d
`ice '� ��PO
.11 • 4,1 te e 44, 454,
4 \
\.: .16•%.*
1 4 ,
O •
•
tn
t• • ' • d
\
• \
. \O
• \
'4 • d•• • \
• •.d \
V.
\
\ ,
• \
\
�� k \
\:
N
UNEM
.O
O r W
O OS 1O•' 0
003 St
•
s