HomeMy WebLinkAboutFalkenbach •
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Town Hall, 53095 Main Road
e r'� �At' �' P.O. Box 1179
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_ 1 �1►� Southold, New York 11971
JUDITH T.TERRY , / rf/./ FAX(516)765-1823
TOWN CLERK TELEPHONE(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. 1041-R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
New Existing X
Name Of Owner FALKENBACH, CARL G.
Mailing Address 1 305 WENDY DRIVE
Mailing Address 2
City St Zip LAUREL NY 11948-0000
Property Address 1 305 WENDY DRIVE
Property Address 2
City St Zip LAUREL NY 11948-0000
Owner Telephone No. 516-298-4903
Tax Map No. section 127.00 block 8 lot 18.000
Cross Street PECONIC BAY BOULEVARD
Date Of Last Pump Out 0/00/00
Issue Date: 3/08/89 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
,••
OFFICE OF THE TOWN CLERK ���-�
Town of Southold QSC
Q Application No. 6 ci
Judith T. Terry, Town Clerk . ,:zs• � � � A►:
Town Hall, 53095 Main Road a .t 1 Residential
P. O. Box 1179 n r ; Non-Residential
Southold, New York 11971 O ®#Le
Telephone '' .'
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
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for
wilA 03 Wag
OPERATION PERMIT
VOA
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE_c._///, .Y7
OWNER NAME: � G /44 /t)51eg
OWNER MAILING ADDRESS: 30,5- dE_Aay
44-ebe -e-- A /fVFI
OWNER PROPERTY ADDRESS: tc-�
OWNER TELEPHONE NUMBER: r"` #3r
TAX MAP NO. : Section /2 ' Block r Lot ir
CROSS STREET: PEC-ojuiC— 34/ 8Lv2)'
TYPE OF SYSTEM: Septic Tank e/ New Existing
Cesspool New Existing
Residential Non-Residential
DATE OF PREVIOUS PUMP-OUT: M7A"E
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 Applicant
RECEIVED BY:
it n Clerk's O fice
DATE: MR 0810
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7 GQ i= MONUMENT
PG V SUFFOLK COUNTY TAX MAP
DIST. 1000 SECT.083 BL.04LOT010
REVISIONS YOUNG & YOUNG
DEC l6,J972 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK
•
"N 7 /373
FE8.2P,/973 ALDEN W YOUNG HOWARD W. YOUNG
[/UNE /5%/9'-'5
3 PROFESSIONAL ENGINEER AND LAND SURVEYOR
..A�1,IVKILtL. AutKAII N MAY 15, 1987 LAND SURVEYOR N.Y S. LIC. NO, 12845 N.Y S. LIC. NO. 45B93
0 THIS SURVEY ISA VIOLATION OF
IiIOt
,ECTION 7209 OF THE NEW YORK STATE SURVEY FOR:
-JUCATIONLgpy CARL G. FALKENBACH et CARMEN FALKE► : BCH -
-OPIES OF THIS SURVEY MAP NOT SPARING!
I3 HE LAND SURVEYOR'S INKED SEAL OR S�P(E OF rye
MBOSSED SEAL SHALL NOT BE CONSIDERED
VALID TRUE COPY R �k. ��
t.
‘+UARANTEES INDICATED HEREON SHALL1"
PNLY TO THE PERSON FOR WHOM THE RUN AT GU • •
5 PREPARED, AND ON HIS BEHALF TO THE RVR]
LAUREL
LJTLE COMPANY S CU' :El;
[HIDING INSTITUTION LISTED HEREON,ERNMENTAL ENA ANG -,-
AP� TOWN OF SOUTHOLD
ID THE ASSIGNEES OF THE LENDING INSTI- CARL
✓TION GUARANTEES C'RME
O ADDITIONAL INSTITUTIONS OpT RANSFERABLF
SURScrI„ BY NDe
SUFFOLK CO., N.Y.
SCALE:, I = 40' DATE: . ,ilii
IINOV. 15, 1972 i:. :vE �. 77