HomeMy WebLinkAboutZagarino t'',®� �®
� ' <
Town Hall, 53095 Main Road
P.O. Box 1179
.�� �� Southold, New York 11971
JUDITH T.TERRY .� to TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 654-R Residential X Non-Residential
Fee $ 10. 00 Septic Cesspool X
New Existing X
Name Of Owner ZAGARINO, FRANK
Mailing Address 1 3620 PALMARITO STREET
Mailing Address 2
City St Zip CORAL GABLES FL 33134-0000
Property Address 1 SOUTH OAKWOOD DRIVE
Property Address 2
City St Zip LAUREL NY 11948-0000
Owner Telephone No. 304-448-4881
Tax Map No. section 145. 00 block 3 lot 3 .100
Cross Street PECONIC BAY BLVD.
Date Of Last Pump Out 0/00/00
157
Issue Date: 3/16/88 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
4 II III
OFFICE OF`THE TOWN CLERK c.31FDCA-
Town of Southold Application51
• CDG ,•
Judith T. Terry, Town Clerk %A*' ,--7
Town Hall, 53095 Main Road . z * ; Residential
P. O. Box 1179 cn 's %' ` Non-Residential
-' '�.
Southold, New York 11971 `O �0���
Telephone _ ( Y► ��
(516) 765-1801
TOWN OF SOUTHOLD .
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
. Tor
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE v" �" � K F-2
OWNER NAME: V' E yt rr-N4
OWNER MAILING ADDRESS: 34,9 S
fl1 .s (6 3.3(0'1
OWNER PROPERTY ADDRESS: $ . Co mea
OWNER TELEPHONE NUMBER: )O6`- <7/4/2— S /
reTAX MAP NO. : Section/ L./ 5 Block 3 Lot cf,VirrVI
CROSS STREET: Pec- 1 ci
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: /�, ` (i t?'
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.)
C
Si; tuof Applicant
RECEIVED BY: .
Town Clerk's Office
DATE: - :
-
7GARINOPHOTOGRI1PHY
ASMP _
3620 PALMARITO STREET • CORAL GABLES, FL. 33134
1-1-& L 0 GA 6ct- ()(....-0,c9c9c( r-
f�
p 01'
ces C<_,, b‘f,
ve
i
b\
MIAMI: (305)448-4881 NEW YORK: (516) 785-0013 • (516) 298-4582