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HomeMy WebLinkAboutBoccio JUDITH T. TERRY Town Hall, 53095 Main Road TOWN CLERK ® P.O. Box 1179 Southold, New York 11971 REGISTRAR OF VITAL STATISTICS Fax (516) 765-1823 MARRIAGE OFFICER - � ��' Telephone (516) 765-1801 RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 3257-R Residential X Non-Residential Fee $ 10.00 New X Existing Name Of Owner BOCCIO, MICHAEL AND KATHLEEN Mailing Address 1 P. O. BOX 7 Mailing Address 2 City St Zip ORIENT NY 11957-0000 Property Address 1 625 UHL LANE Property Address 2 City St Zip ORIENT NY 11957-0000 Owner Telephone No. 516-323-2618 Tax Map No. section 15.00 block 5 lot 24.009 Cross Street RYDER FARM LANE Issue Date: 10/06/94 Judith T. Terry Southold Town Clerk (TOWN SEAL) - - cam • O';AFICE OF THE TOWN CLERK 'c�vFF0ifi' - Town of Southold OST, CQG Application Judith T. Terry, Town Clerk iw $10.00 - Residential '— Town Hall, 53095 Main Road �r� P. O. Box 1179 cry �. , '',�� ' �` $25.00 - Non-Residential Southold, New York 11971 O ® Ar `j� *$ Telephone _0? (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ DATE /-6/43-4y OWNER NAME: 47/61dNEL fr/f4.7-77t2,66„A_)6-RJ I:.1GGccio OWNER MAILING ADDRESS: 6,95" 0/72k_ �,_,I1��� 4/30X '7- /C) - /CJ y _IA96 OWNER PROPERTY ADDR-ESS: ��� � � - e"ec/�au rf,J 1 1/167 OWNER TELEPHONE NUMBER: TAX MAP NO. : Section Block �� - Lot a/{, 9' CROSS STREET: tg ptiZ. 6mm Li ,J TYPE OF SYSTEM: Septic Tank Ace 57 New ?0,0674L__E>ieti< Cesspool New Existing Residential Non-Residential 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.) / Signatur of Applicant RECEIVED BY: 'Town Cllerk's Office DATE: Q � // � . . • _ . . , • , , • .... . . ,.., . . , . .. • .., , . _ 42 .,•: __ , _ A.ALTERATION OR ADDMON TO THIS StAVEY IS A VIOLA. . ... . . . . _ . _ _ _ . ' - . . . ' i r OF SECTION 7209:0F.71E AEW,YOIN STATE EDUCATION•LAW . , _, ,,, . - ,, _. .., • „ -,, _,, ,_ . ". '•'-r.',.. • - • , -. , . . • , r r..--.:', ,, - ,,r -''--rr" A6.3 -,' , - ' ,, - _HEREON ARE.YALID_FOR MS MAP-AND COPESIIEREOFONL: . SAD MAP COPES BEAR,71E-STRESSED SEAL OF. , .., . , , " WHOSE SIGNATURE-APPEARS HEREON, .„...„ ,.._ • . . . ' . . , ,, ,. . , „ , . , , • r ,,. , _ ,,__ , , . • , • .• :" ''. - _.. , _ ' - - -• ` "rr " - ", r• ADDITIONALLY TO COMPLY,S7TH-SAID LAW THETERM ALTILT , '' - -''-- • ' :' '-- - '. ---- - r' - - '"' r''.r'' - ' - .' - '' ' r ' ------- - ,.';" . - '-- MUST SE USED AAV ALL SURVEYORS WM-6A'CO .,• . ... 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