HomeMy WebLinkAboutCassimatis OFFICE OF THE TOWN CLERK •
Town of Southold c. [11..1(.G�
Judith T. Terry, Town Clerk • �
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Town Hall, 53095 Main Road ,..
P. 0. Box 1179 i
Southold, New York 11971 p ' • , ' •�
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Telephone _4-P40/
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
CORRECTED
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 470 Residential x
Non-Residential
Fee $ 10.00
Septic Cesspool x
NAME OF OWNER: Nick Cassimatie
OWNER MAILING ADDRESS: 150 Captain Kidd Drive, P.O. Box 829
Mattituck, New York 11952
OWNER PROPERTY ADDRESS: 150 Captain Kidd Drive
Mattituck, New York 11952
OWNER TELEPHONE NUMBER:. 516-298-4459
TAX MAP NO. : Section . 106 Block 3 Lot 26
CROSS STREET: Breakwater
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing x
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: Unknown
•
udith T. rry
Southold Town Clerk
DATE: October 21 , 1987
Corrected Permit Issued November 6, 1987
(TOWN SEAL)
OFFICE OF THE TOWN CLERK .c0FOUrt?
Town of Southold Q �G
Judith T. Terry, Town Clerk 4-r44(0. z:
Town Hall 53095 Main Road fir'
P. 0. Box 1179 1 cn Vt fi
Southold, New York 11971 p ® , 0����
Telephone -?i rzt $�
(516) 765-1801
•
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 470 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool x
NAME OF OWNER: Nick Cassimatis
OWNER MAILING ADDRESS: 150 Captain Kidd Drive, P.O. Box 829
Mattituck, New York 11952
OWNER PROPERTY ADDRESS: 150 Captain Kidd Drive
Mattituck, New York- 11952
OWNER TELEPHONE NUMBER:, 516-298-4459
TAX MAP NO. : • S (tion 5 L t 2S
CROSS STREET: Breakwater
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing X
+ Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: Unknown
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1641gludith T. rry
Southold Town Clerk
DATE: October 21, 1987
j (TOWN SEAL) 1
I
OFFICE OF THE TOWN CLERK ••COFDC,r =
Town of Southold � „ , �Q ' , Application No.�70
Judith T. Terry, Town Clerk ��� ,5t _ Residential
Town Hall, 53095 Main Road o � ,, � M
P. O. Box 1179 cn "� ` ' �' Non-Residential
Southold, New York 11971 O 4 . 0 •�`
Telephone '®.!~ "Z
•
(516) 765-1801 -
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ M .
DATE /61 4F2
OWNER NAME: 7,/d4" alic0/1 -//./
OWNER MAILING ADDRESS: /5-0 ("2.•—d ,di) e) ip9,
#7-77IVCK, Y
OWNER PROPERTY ADDRESS:
OWNER TELEPHONE NUMBER: X71°- 4s //6/77
TAX MAP NO. : Section /OA Blockff/L.5Lot . 5-;"'
5
CROSS STREET:
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential Non-' -side ial
DATE OF PREVIOUS PUMP-OUT: 4G
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.)
• '` mil _��
Signature of Applicant
RECEIVED BY:
Town C rrk's Of ice
DATE: 6k4 4/. /- e-7
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