HomeMy WebLinkAboutEngel Town Hall, 53095 Main Road
�® ® P.O. Box 1179
® �® Southold, New York 11971
JUDITH T.TERRY - `� TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 644-R Residential X Non-Residential
Fee $ 10. 00 Septic Cesspool X
New Existing X
Name Of Owner ENGEL, RUTH
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Mailing Address 1 P. O. BOX 497
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Mailing Address 2
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City St Zip MATTITUCK NY 11952-0000
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Property Address 1 845 BAYER ROAD
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Property Address 2
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City St Zip MATTITUCK NY 11952-0000
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Owner Telephone No. 000-000-0000
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Tax Map No. section 107. 00 block 9 lot 24. 000
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Cross Street MARY`S ROAD
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Date Of Last Pump Out 0/00/00
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Issue Date: 3/08/88 Judith T. Terry
-------- Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK
Town of Southold ��� CQG Application No./6/
Judith T. Terry, Town Clerk ,
Town Hall, 53095 Main Road c -� Residential
P. 0. Box 1179 Ul Non-Residential
Southold, New York 11971 O ® V F
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $
DATE
OWNER NAME:
OWNER MAILING ADDRESS:
OWNER PROPERTY ADDRESS: '_
OWNER TELEPHONE NUMBER:
7 TAX--MAP NO. : Section O rl Block Lot
CROSS STREET: } Ru,SD-q �L
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool / New Existing �-
Residential 1( Non-Residential
DATE OF PREVIOUS PUMP-OUT: A\ vtib,-a1(
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.)
Signature of Apis nt
RECEIVED BY:
Town Clerk's Office
DATE:
TITLE N0. 7908-082671
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NO TE:
SUBDIVISION MAP FILED/N ME OFF/CE
OF THE CLERK OF SUFFOLK COUNT Y ON
JUL Y 24,/935 AS MAP NO. //84.
F '
i
SURVEY FOR
RUTH ENGEL
LOT 42 IsAMENDEDMAP OF MATTITUCK HEIGHTS"
AT MATTITUCK DATE SEPT. 24, 1979
TOWN OF SOUTHOLD SCALE: I" = 30'
SUFFOLK COUNTY, NEW YORK NO. 79-495
X UNAUTHORIZED ALTERATION OR ADDITION TO THIS GUARANTEED TO:
SURVEY IS A VIOLATION OF SECTION 7209 OF THE CHICAGO TITLE INSURANCE CO.
NEW YORK STATE EDUCATION LAM/
*COPIES OF THIS SURVEY NOT BEARING THE LAND
SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL
NOT BE CONSIDERED TO BE A VALID TRUE COPY N .�
XGUARANTEES INDICATED HEREON SHALL RUN ONLY TO Of y
THE PERSON FOR WHOM THE SURVEY IS PREPARED
AND ON HIS BEHALF TO SHE TITLE COMPANY,GOVERN— y qty �(?�'•,� +1
MENTAL AGENCY AND LENDING INSTITUTION LISTED
HEREON,AND TO THE ASSIGNEES OF THE LENDING
INSTITUTION GUARANTEES ARE NOT TRANSFERABLE
T ADDITIONAL INSTITUTIONS OR SUBSEQUENT
OWNERS = t eay'.�;•-:� jit�:t� s:
*DISTANCES SHOWN HEREON FROM PROPERTY LINES m �' `• pp
TO EXISTING STRUCTURES ARE FOR A SPECIFIC plj
?
PURPOSE AND ARE NOT TO BE USED TO ESTABLISH
PROPERTY LINES OR FOR THE ERECTION OF FENCES
r GtN
YOUNG a YOUNG � R AVENUE
RIVER HEAD, NEW YORK
ALDEN W YOUNG,PROFESSIONAL. ENGINEER
AND LAND SURVEYOR N.Y_S LICENSE NO.12845
HOWARD W.YOUNG, LAND SURVEYOR
N.Y S LICENSE NO 45893
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