HomeMy WebLinkAboutCaiola SL
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Town Hall, 53095 Main Road
„••%-...t' P.O. Box 1179
=-r-ti �,'' Southold, New York 11971
„/,�,,i' FAX(516)765-1823
JUDITH T.TERRY TELEPHONE(516)765-1801
TOWN CLERK
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. 1572-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner CAIOLA, SAL
Mailing Address 1 230 EAST 85TH STREET
Mailing Address 2
City St Zip NEW YORK NY 10028-0000
Property Address 1 125 NORTH ROAD
Property Address 2
City St Zip SOUTHOLD NY 11971-0000
Owner Telephone No. 212-772-8830
Tax Map No. section 51 .00 block 3 lot 9.001
Cross Street OLD NORTH ROAD
Date Of Last Pump Out 0/00/00
Issue Date: 10/30/90 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
\ ,
OFFICE OF T-H TOWN CLERK .0 TOWN
TGwn of Southold Q C� • Application No. /J-
Judith T. Terry, Town Clerk t
Town Hall, 53095 Main Road1-, ;; 3 $10.00 - Residential v
P. 0. Box 1179 ? = ` tri ` $25.00 - Non-Residential
Southold, New York 11971 `®: '
Telephone _�j Y►�
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ I -
DATE i 01 ZLi 11°1 0
'OWNER NAME: j ql CcLoGj
OWNER MAILING ADDRESS: 230 3 Ste }
U e G)( 0(5-2_.(8c
9
OWNER PROPERTY ADDRESS: \'2.5 � t
! tL 1 \°n
OWNER TELEPHONE NUMBER: 7 1-2 - `1 O
TAX MAP NO. : Section Block 3 Lot 9
CROSS STREET:
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool a/ New Existing
Residential ✓ Non-Residential
DATE OF PREVIOUS PUMP-OUT.: c -:; ,@ q
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.)
Signa'ure of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
ti Country Cesspool & Drain Service
. 168 Central Avenue
— Greenport, New York 11944
(516) 477-0540
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