HomeMy WebLinkAboutBrandi OFFICE OF THE TOWN CLERK • F�
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Town of Southold
Judith T. Terry, Town Clerk Sr 1.4:a
53095 Main Road =
Town Hall, o ,� _ •,,,, z�
P. O. Box 1179 i�� =j
Southold, New York 11971 V-
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
OPERATION PERMIT
• SEPTIC TANK or CESSPOOL
Operation Permit No. 483 Residential X
Non-Residential
f Fee $ 10.00
Septic Cesspool x
NAME OF OWNER: Anthony J. Brandi & Wife
OWNER MAILING ADDRESS: 1845 Henrys Lane
Peconic, New York 11958
OWNER PROPERTY ADDRESS: 1845 Henrys Lane
Peconic, New York
OWNER TELEPHONE NUMBER: 516-765-5349
TAX MAP NO. : Section 74 Block 1 Lot 7
CROSS STREET: Soundview Avenue Ext.
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool X New Existing x
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: August 1986
•
MON
Judith T. Terry
Southold Town Clerk
DATE: November 17, 1987
((TOWN( SEAL) _
• ear
OFFICE OF THE TOWN CLERK II c3IFD1,-�''
Town of Southold �� �Q�•; Application No.
Judith T. Terry, Town Clerk
Town Hall, 53095 Main Road �, ; .�- -G I Residential
N;A•
P. O. Box 1179 to * _ �`' Non-Residential
Southold, New York 11971 O `®. ,'''
Telephone *02.'
(516) . 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for - -
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. Zif,�
Fee $ (Q. i
DATE //-//- g7
OWNER NAME: 14nl r blvnl KA&d Gd/G
OWNER MAILING ADDRESS: �rfe�� (/ei PILI 14-1
edAJi?-c__ Aq a I seY
OWNER PROPERTY ADDRESS: S11412
OWNER TELEPHONE NUMBER: 1-74S-----,S-3 Li?
TAX MAP NO. : Section L' Block / Lot 7
CROSS STREET: 5cvcQ c e. EK7-0,11S- �
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: l ( qr Co
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.)
417,"
Signa ure of Applicant
RECEIVED BY: • •
_•�� . _
RC1ir n Cl! 's Offi/
DATE: NOV 171987
lawn Clerk Southold
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Sec < 84,4 , 47 7
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