HomeMy WebLinkAboutCatalano OFFICE OF THE TOWN CLERK ' 'C0FOL.
Town of Southold � CSG
Judith T. Terry, Town Clerk = ,
Town Hail, 53095 Main Road 8'
P. O. Box 1179 v'
Southold, New York 11971 •
Telephone =®1 t se0
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
- Operation Permit No. 36 Residential
Non-Residential
Fee $ 10.00
• Septic Cesspool xx
•
NAME OF OWNER: Andrew Catalano
OWNER MAILING ADDRESS: Main Road
Peconic, New YOrk 11958
OWNER PROPERTY ADDRESS: Main Road
Peconic, New York
OWNER TELEPHONE NUMBER: 765-1925
TAX MAP NO. : Section 86 Block 1 Lot 3.1
CROSS STREET: Peconic Lane
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool XX New Existing xx
Residential xx Non-Residential
DATE OF PREVIOUS PUMP-OUT: July 22, 1986
ossreoee4e:
Southold Town C
DATE: September 4. 1986
-
i , -(TOWN SEAL)
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OFFICE OF THE TOWN CLERK cvFFRA'�'•
Town of SoutholdCQG' Application No.„76
Judith T. Terry, Town Clerk . 4.0 i y
Town Hall, 53095 Main Road � . '< 1 Residential
P. O. Box 1179 t �= ! ' `'
��{ „. � Non-Residential
Southold, New York 11971 O o.w OO�
Telephone
.(
(516) 765-1801
D''"TIVED TOWN OF SOUTHOLD
SEP 0 2 In SOUTHOLD WASTEWATER DISPOSAL DISTRICT
Clark Southo9
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No36,
Fee $
DATE
OWNER NAME: A Af/1/?LV WWW 6114 I 4 4"0
OWNER MAILING ADDRESS: /f1/1/ )
OWNER PROPERTY ADDRESS: ft: CO/Y/ C i/. mil r ii4.4/4/ Rj>
OWNER TELEPHONE NUMBER: 7,‘'S`/ 91.2T‘
TAX MAP NO. : Section d(-6" Block /..„. 12---ALot a.
CROSS STREET: P_to
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential ' Non-Residential
DATE OF PREVIOUS PUMP-OUT: 1
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.)
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nature o pp.licant
9
RECEIVED BY: c c(a
Town erk's Of ice
DATE: J
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