HomeMy WebLinkAboutRudolph "IF OF Mit
ELIZABETH A.NEVILLE � ® 'k ®�� Town Hall, 53095 Main Road
TOWN CLERK ® xr P.O. Box 1179
4 co Southold, New York 11971
REGISTRAR OF VITAL STATISTICS �'�� Fax(516) 765-1823
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER :�®� e�®�0set Telephone (516) 765-1800
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. 3763-R Residential X Non-Residential
Fee $ 10.00 New Existing X
Name Of Owner RUDOLPH, JOSEPHINE H.
Mailing Address 1 P. O. BOX 1256
Mailing Address 2
City St Zip MATTITUCK NY 11952-0922
Property Address 1 NEW SUFFOLK AVENUE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-4788
Tax Map No. section 115.00 block 5 lot 10.000
Cross Street MEADOW LANE
Issue Date: 2/13/98 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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OFFICE OF THE TOWN CLERK _ ' 3110 •�"
TOWN OF SOUTHOLD 0� `�'. cG : Application No. 3 7�
ELIZABETH A.NEVILLE,TOWN CLERK °' 4; a,
.a .G 7 $10.00 - Residential
P.O.BOX 1179 to A . ;;;� a �,
SOUTHOLD,NEW YORK 11971 � r �*�,. '� 1��`
$25.00 - Non-Residential
Telephone %.( 0-/
(516) 765-1801 .,�
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ [ 0
DATE r r v
OWNER NAME: —Sc,SE141‘ 1\( H. R0 -, p7
OWNER MAILING ADDRESS: ( i L, jM p i T j 711 dGR1
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OWNER
615OWNER PROPERTY ADDRESS: Ni.4/ Su Fro I- R / U h4a"A (DooV• c O"
OWNER TELEPHONE NUMBER: aQP-' L4'f
TAX MAP NO. : Section 473 rg Block I / Lot / 0
CROSS STREET:
TYPE OF SYSTEM: Septic Tank / New Existing
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.)
94-'
Signature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE:
.
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Lot 44
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'`�f CT1 fan,�c/` A r ��'/// \ B \ ( UNAUTHORIZED ALTERATION OR ADDITION i
\ y4. TO THIS SURVEY ISA VIOLATION OF
4. ' CS i ,}1 SECTION 7209 OF THE NEW YORK STATE ,�
LI �- ry�l /\ I \ \ NO,TE� EDUCATION LAW
i � b \ ■=MONUMENT ,
}' 1 \ SUBDI VI S/ON MAP FILED IN THE OFFICE
COPIES OF THIS SURVEY MAP NOT BEARING
{ � ; - \ II THE LAND SU;VLYOR'S :PIKED SEAL OR �'�-
I' � srPOO� , � ^�� OF THE CLERK OF SUFFOLK COUNTY ON EMBOSS!D SIAL SHALL NCI BE CONSIDERED
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�� J - SEPT. 8, /965 AS MAP NO. 4453. To BE A v.� r r,uE CC FY. i;
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-,.Y� GUA°AD.TCS \ iCAPD HEREON SHALL RUN
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_'r; REVISIONS YOUNG & YOUNG
'I' JUNE 7,I972 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK v:. \
`',, ,,1 ll; „ NO V. 14,1972
�' APR. 17 1973 p LDEN,W. YOUNG HOWARD W. YOUNG
. rl., �I 1 PROFESSIONAL ENGINEER AND LAND SURVEYOR
ih
i .L i' LAND SURVEYOR, N.Y.S. LIC, NO, 12845 N.Y.S. LIC. NO 45893
:145� SURVEY FOR: �� of :z
: Y EDWARD G. ABITZ• PRD U,: y ��
I" e !`1 LOT 45 ,I MATTITUCK ESTATE"Doi �° I - 2
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AT .\, \
MATTITUCK GU• RA TEE
e N° g3
: = TOWN OF SOUTHOLD rF4Jr( ' 453 0�
�'IWD SURa�� ',',:r)•�
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• j,` .SUFFOLK CO., N.Y. Hy/v/0,(7,_/t/, �� Puiu�
b v ; ; „a :' : '? SCALE:• I" = 4O� DATE:MAY 18, 1972 No. 72-379
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