HomeMy WebLinkAboutBertetto OFFICE OF THE TOWN CLERK �c�VFFOU(��
Town of Southold G _
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road
P. 0. Box 1179
Southold, New York 11971 Off` 0N- •�,
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Telephone �t
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT •
SEPTIC TANK or CESSPOOL
Operation Permit No. 228 Residential X
Non-Residential
Fee $ 10.00
Septic Cesspool X
NAME OF OWNER: Frank Bertetto
OWNER MAILING ADDRESS: P.O. Box 134
Greenport, New York 11944 •
OWNER PROPERTY ADDRESS: 3 Shore Drive •
Greenport, New York'
OWNER TELEPHONE NUMBER: 516-477-1574
TAX MAP NO. : Section 47 Block 2 Lot 18
CROSS STREET: Silvermere
TYPE OF SYSTEM: Septic Tank X New Existing x
Cesspool X New Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: November 1986
•
Judith T. Terry
Southold Town Clerk
DATE: February 23. 1987
(TOWN ,SEAL)
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OFFICE OF THE TOWN CLERK cOFOUr��=
Town of Southold �� �Q ' , Application No. ?�I
Judith T. Terry, Town Clerk �`
Town Hall, 53095 Main Road c Residential
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P. O. Box 1179 cn ' _. � `' Non-Residential
Southold, New York 11971 O6 :,c\sr
Telephone -70
•
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. aok
Fee $ /b•-�
DATE
•
OWNER NAME: rfw+tk Te o
OWNER MAILING ADDRESS: tQ t0T 011
OWNER PROPERTY ADDRESS: 90e, 0,11\eQ
VONA
OWNER TELEPHONE NUMBER: 1-171-t514
TAX MAP NO. : Section Lci Block ;, Lot tog
CROSS STREET: AV14tyneft
TYPE OF SYSTEM: Septic Tank • New Existing °'
Cesspool v New Existing J
Residential 1 Non-Residential
DATE OF PREVIOUS PUMP-OUT: KW ;y( 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.)
Sig afure of Applicant
RECEIVED BY: rViix „ ,� � �, �0_4_/
RECEOVECTown Clgerk's Offke
DATE: CER 9 lg537
'own C!ek Southold
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