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HomeMy WebLinkAboutBrisotti . /14f cf00A.6* Town Hall, 53095 Main Road, ® O � `� P.O. Box 1179 %*4;41 Southold, New York 11971 JUDITH T.TERRY "= „i�%�1FAX(516)765-1823 TOWN CLERK TELEPHONE(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. 1313-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New Existing X Name Of Owner BRISOTTI, ALBERT A. Mailing Address 1 P. O. BOX 341 Mailing Address 2 City St Zip MATTITUCK NY 11952-0000 Property Address 1 4700 OLE JULE LANE Property Address 2 City St Zip MATTITUCK NY 11952-0000 Owner Telephone No. 516-298-5810 Tax Map No. section 122.00 block 4 lot 35.000 Cross Street KRAUS STREET Date Of Last Pump Out 0/00/00 Issue Date: 11/20/89 Judith T. Terry Southold Town Clerk (TOWN SEAL) .'.. .OFFICE OF THE TOWN CLERK t0F00( Tow.h of SoutholdQ C' : Q ' Application No. /3/,3 Judith- T. Terry, Town Clerk 1 Town Hall, 53095 Main Road ' ,r . $10.00 - Residential l." P. O. Box 1179 cn .4 ;_• fi $25.00 - Non-Residential Southold, New York 11971 O ® wz '' •v` Telephone Q( It (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICAT ION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 13/3 Fee $ /O DATE ////3/k9 OWNER NAME: gi. Si(,e A . Bps077-7 OWNER MAILING ADDRESS: O f®x 34 / A-TrirN ck / /V Y. //g//SZ OWNER PROPERTY ADDRESS : 4 ) Od Q i iALe L,gfF / 11 TT)Tic-k OWNER TELEPHONE NUMBER: 2.98- _ c$/6 43.5 TAX MAP NO. : Section -�$-� Blockck Lot —114—' CROSS STREET: Kfi(V4( S Si- TYPE OF SYSTEM: Septic Tank a New Existing Cesspool / New Existing Residential Non-Residential DATE OF PREVIOUS PUMP-OUT: 7 /24 /87 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.) Signature of Applicant RECEIVED BY: 46,Lac, 41Q Townerk's ffice DATE: .l.,piL) 62.0 /9/`i - ` ' 1 tr.,' . ``, . 1 \^ ..`,f^. � . � ' ' -' . ' ._ ^- • ����.` � � � . ! ' �, � ` ' ' V� ^��� , ~ / / \ ~ � / ' `-' ! t~ ������ -'--' - -' r--------- '-----'~^-~�^'- ~`~- ~-''-~^^�-'-- ----- --' - - - - -- '' } ` ` - __-_-___--__-- ---_- _--___--__+- ' _-.___ -' -- ---___ - -__'-_ -_ _ -- - . . _ ' � ����� , ��� � �-~ ���� �^'� � . '�~-__' - ' '-_+�-___'--._-_' � � � '_^_--_--_--_^--- ---_--__ ----_� ___-_-_ _-'-_---'__- !lap Fr -- ---'------i--- -- -- -----y~---- ---------'--'---- '-----'-'---'---- ---'------- - ' �� «�. . �9? t) - � ~~ +_----_'_-- . . _--� / v -__- --' '-�-, '_ -_- ---_-'-____^--___._-�_---_--__.'---'--_ _ --_------__--_-_- ___- L _,„.....-----______--_-------'--- ------'---�---------'---' , ` ' � yr- . ( ����� �w~^ , ! _ . -- - ----' ---------------------------'-----'--------'- - - i -- | ^ . . _ . ' -��'�������������_��� `.- - ! '_ --_-_- - - -.--_ - - - �- _-- -__----__ '_-_-_----- _-�- ' - '-' _ - ' -- --'---_-. ---- . ' ‘: �_ __ __ �___--_-_ _-_'_-- __�_-- __ '. , - _ / / ' _ - - ' '' -' _ .....-_ '- - - ' . _ . - . , _ .... ..._ . _ - _--- _' _- '__- ____'---_---_'__ -''--' _ -' -.- --' - . - ' _ .. ! -- - ^-` `--------- --`--------------- --` -`- ` ` - - - - - ` - ---- -`- . _ - L-_--' ----_- --__''____---_- - - ' ._'_ _ - ' '_ - ' _- - -- ---' | - ' ' ;-_ � . - -- - - -- - -- ---- ----. -- - - / - _- __,__ , --' ' -- -_-' --' . - -_ --_ - | -- |--- I