HomeMy WebLinkAboutVillano eor
�
JUDITH T.TERRY ��� �: Town Hall, 53095 Main Road
TOWN CLERK y P.O. Box 1179
.s► � Southold,New York 11971
REGISTRAR OF VITAL STATISTICS O
MARRIAGE OFFICER
y ,1� Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER �_�®1 41 `t►►1•,p,' Fax
(516) 765-1800
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. 3511-R Residential X Non-Residential
Fee $ 10.00 New X Existing
Name Of Owner VILLANO, WILLIAM A. AND EILEEN
Mailing Address 1 190 CENTRAL DRIVE
Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
Property Address 1 MILL ROAD •
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-3209
Tax Map No. section 106.00 block 9 lot 8.003
Cross Street MILLER ROAD/BAYVIEW AVENUE
Issue Date: 9/23/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
n
•
OFFICE OF THE TOWN CLERK 'COFULA,,-
Town of Southold �� - CSG=� Application No. 3,3'�//
Judith T. Terry, Town Clerk .� ' "� y
f, � � 7 $10.00 - Residential
Town Hall, 53095 Main Road 8 z
P. O. Box 1179 w , t F `:' ► i' $25.00 - Non-Residential
Southold, New York 11971 �0 �
Telephone _
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
• SEPTIC TANK or CESSPOOL
Operation Permit No. 1506 R
Fee $ 10.00
DATE "-a®
OWNER NAME: Villano, William A. and Eileen
OWNER MAILING ADDRESS: 190 Central Dr.
Mattituck, nY. #11953
OWNER PROPERTY ADDRESS: Mill Rd.
Mattituck, NY. #11952
OWNER TELEPHONE NUMBER: ( 516) 298-3209
TAX MAP NO. : Section 106 .00 Block 9 Lot 8 .003
CROSS STREET: Miller Rd ./Bayview Ave.
(8z, /5 -/5/�.)
TYPE OF SYSTEM:- Septic Tank New XX Existing _ ___•_
Cesspool New XX Existing
Residential XX 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.)
Vel&44.,9-"
Signature of Applicant
William A. Villano
RECEIVED BY:
Town Clerk's Office
DATE: „9_--6 / l
co,
114:116
99
1
Vv