HomeMy WebLinkAboutBozzo OFFICE OF THE TOWN CLERK
Town of Southold � ''' C&l/
Judith T. Terry, Town Clerk '4 �.�, J'
Town Hall 53095 Main Road c".?'
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P. 0. Box 1179 �� '::
Southold, New York 11971 \ per`® � $
Telephone , �l
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 480 Residential X
Fee $ 10.00Non-Residential
Septic Cesspool X
NAME OF OWNER: Eugene D. Bozzo
OWNER MAILING ADDRESS: 48 Foothill Lane
East Northport, New York 11731
OWNER PROPERTY ADDRESS: Camp Mineola Road
Mattituck, New York 11952
- OWNER TELEPHONE NUMBER: 516-266-2183
TAX MAP NO. : Section 1�3 Block 5 Lot 27
CROSS STREET: Reeve Avenue/Kraus Avenue
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool x New Existing X
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: Unknown
e - ,
Judi h T. y
Southold Town Clerk
DATE: November 9, 1987
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(TOWN SEAL)
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OFFICE OF THE TOWN CLERK ��FO(,(�''
Town of SoutholdCQ ' Application No. !'0�
Judith T. Terry, Town Clerk
Off, ;� �.. G %,
Town Hall, 53095 Main Road o ' .` `. < I Residential
fi
P. 0. Box 1179 y' �, Non-Residential
Southold, New York 11971 �
Telephone '0°��`
(516) 765-1801 = 1 �O�
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
RECEV �+. APPLICATION
OCT 22 1, 7 tor
Town Mork Southold OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Perm' No. 1P
Fee $
• DATE
OWNER NAME: /1
OWNER MAILING ADDR
OWNER PROPERTY ADDRESS: _..'
r
OWNER TELEPHONE NUMBER: I
TAX MAP NO. : Section A Block L Lot 210"7
CROSS STREET: s/�® —itifAtef/ /4* a. .
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool c New //Kxisting
Residential Non-Residential
- DATE OF PREVIOUS PUMP-OUT: 41./(10441#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.)
Sisti� atur•,. Applicant
RECEIVED BY: cz,
Town gerk's ffice
RECEIVED
DATE:
NOV O91987
l own C'.Ark Southold
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