HomeMy WebLinkAboutVitale (2) I' '.moi
JUDITH T. TERRY • yt Town Hall, 53095 Main Road
TOWN CLERK Z P.O Box 1179
REGISTRAR OF VITAL STATISTICS MI`I Southold, New York 11971
MARRIAGE OFFICER . �•� Fax (516) 765-1823
• 0 ®� • Telephone (516) 765-1801
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 1662-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner VITALE, BRUCE AND MELINDA
Mailing Address 1 7280 SOUND AVENUE
Mailing Address 2
City St Zip MATTITUCK NY 11952-0000
Property Address 1 7280 SOUND AVENUE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-5636
Tax Map No. section 121 .00 block 5 lot 2.000
Cross Street COX NECK
Date Of Last Pump Out 0/00/00
Issue Date: 4/08/91 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
•
w� R I, • •ice
OFFICE OF THE TOWN CLERK c�vFFo(,Ir
Town of Southold � . CSG', Application No. / (, 6
Judith T. Terry, Town Clerk ` y:`
t *•::1 -G $10.00 - Residential
Town Hall, 53095 Main Road '�•11- }�
cn "_�% , i• ` $25.00 - Non-Residential
P. O. Box 1179 ��, �� . � �
Southold, New York 11971 O _® ''
Telephone 1jgdI
•
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
PACES •
for
MAR 271991
Ton clerk Southold OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. I 4. 4 oZ
Fee $ , o 7)
DATE 0.2lo1J ic7
OWNER NAME: Brute -± HedlfCL& UJ +a. It. •
OWNER MAILING ADDRESS: /c)-Sb &) AVd APE.
m Aly 1 l Q S" 2
OWNER PROPERTY ADDRESS : 5 cx/rYLLL
OWNER TELEPHONE NUMBER: 5103 (4
TAX MAP NO. : Section I a I Block Lot Z
CROSS STREET: ecy Neck_
TYPE OF SYSTEM: Septic Tank New X Existing
Cesspool New Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: 12- )31 9O
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.)
ILA4rAilo
Signature of Applicant
RECEIVED BY: es.1 "Air,
iwn CI .rk s I fice
DATE: V a7 //
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