Loading...
HomeMy WebLinkAboutCosenzo ell If 01. tA JUDITH T. TERRY . . Town Hall, 53095 Main Road TOWN CLERK v T P.O. Box 1179 REGISTRAR OF VITAL STATISTICS 5212�® �` Southold, New York 11971 MARRIAGE OFFICER , Fax (516) 765-1823 ,y®1 %K. Telephone (516) 765-1801 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 2045-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New Existing X Name Of Owner COSENZO, SANTALO A. Mailing Address 1 740 NAKOMIS ROAD - Mailing Address 2 City St Zip SOUTHOLD NY 11971-0000 Property Address 1 740 NAKOMIS ROAD Property Address 2 City St Zip SOUTHOLD NY 11971-0000 Owner Telephone No. 516-765-5329 Tax Map No. section 78.00 block 3 lot 33.000 Cross Street HIAWATHA'S PATH Date Of Last Pump Out 0/00/00 Issue Date: 2/22/93 Judith T. Terry Southold Town Clerk (TOWN SEAL) OFFICE OF THE TOWN CLERK c,VFFD(k��' Town of Southold �� ,- CQG Application No. ,04/� Judith T. Terry, Town Clerk ‘ N`t411, '• :} Town Hall, 53095 Main Road $10.00 - Residential P. 0. Box 1179 cr's t, ' hi . $25.00 - Non-Residential Southold, New York 11971 O ® a �O� Telephone 61 N� '" (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERAT ION PERMIT SEPTIC TANK or CESSPOOL • Operation Permit No. 02 01--/5 Fee $ ) b , aI) DATE 1 d,. -y7 / �/ 73 OWNER NAME: _ ,,,!A . .LA. 0 - At OWNER MAILING ADDRESS: e) O "I lS' /2,O `'61r7-7©Z._F 7/ ______ . OWNER- PROPERTY ADDRESS: - - - - -- 5 iq 47, /- OWNER TELEPHONE NUMBER: 176 .4— r--5- ���.j �' 1 TAX MAP NO. : Section 7 Block 3 Lot 3 CROSS STREET: A,____ __�� : f ' TYPE OF SYSTEM: Septic Tank , _New Existing ir Cesspool New Existing Residential / Non-Residential DATE OF PREVIOUS PUMP-OUT: / E6 . I 1-1 / 9 9 Y LOCATION MAP: Must be attached hereto before perms may be issued. (Locate building and system; give n rth arrow and feet of distance, approximately, to building and closest road.) Amy"(4-4, :71-a---4) d. i6,-(_.}(56 Signature of Ap. scant 7- RECEIVED BY: i' - - Towt Clerk' Office DATE: /77 73 S:::: 1993 IffiIUwn C eyk SO 60 77') et<4-1/13e_,11-`' --- ..,, .._-- ,... .-.,....... .-...... .----------, ) ....-1 I 1 ‘ 11 . ' 1 1 . ' , . . , ' . . k. . ,. • , , ct) k." -- ,....... .-, • :/i ;',,t-j2):, ' ,,,,,,\,-,- , . , - . ,,,,, • --, , ,-,----. ..:i ‘I. ••,......,,z,..-" - -:---,k,/ ‘ 1 , c, „, , , , „, \ ii ,,, . . , ,,..,...„ ,, ,, , , , . 1 /.. s. . ,.. ,,, ,:,„, . ?...,,,, , V . ,•,"--- r i[/- i' ,'; '4 ... .-----.`ti ,,.. /?/7:-i, \ ' \ 71---A,_,. A , • i/ il , A ,,. „„, ./, y _..,, I.'S / 7' : 7 /'i ' 1 C11.---- 7-'. 4(,„._)0 • , '' , - I t , -L-4-, ‘,..,„_.__.• , ,_, , ,1, l N;r: , 1 1) kt, ' ! ''• - - - -- I - - - ''-- 1 , -- -, , ,, ,,.._._ ., _. A.... . P ,.. I, -'------- :" 27-'-'-' I -re iff/ , A , , .,• r„,1....._-_, , r i \\ /j ' • , v , 1----- - , / , ' • • . .,----j';'---. 1 11/ 1 _ CV . C\ \\.. .: , \ "' ' ' ,fi;fif, ', I , , , ,.. 0e.„,:„ ;.,,c„ •" , / .• ,....,_ . , ..•iv,.., 4•",..... ,, „,..4 ,,.. ,,,,,, .1 / o - 729 N 9/k.-0 /)'2'Tc „if,i7)D yriroi\I r L' 1