HomeMy WebLinkAboutRaacke OFFICE OF THE TOWN CLERK
Town of Southold OC��SFU( ���
Judith T. Terry, Town Clerk
,G�
Town Hall, 53095 Main Road ,,t
tli
P. 0. Box 1179 cr3 - k .
Southold, New York 11971
Telephone zad
(516) 765-1801 -
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
•
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 569 Residential x
Non-Residential
Fee $ 10.00
Septic Cesspool
NAME OF OWNER: Robert and Barbara Raacke
OWNER MAILING ADDRESS: Box 816. Westphalia Road
Mattituck. New York 11952
OWNER PROPERTY ADDRESS: Westphalia Road
Mattituck, New York
OWNER TELEPHONE NUMBER: 516-298-8687 .
TAX MAP NO. : Section 113 Block 13 Lot 144
CROSS STREET: Silkworth Road
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool x New Existing x
Residential X Non-Residential
DATE OF PREVIOUS PUMP-OUT: Sept. 15. 1987
•
o �r •
Judith T. Te
Southold Town Clerk
DATE: January 11 . 1988
(TOWN SEAL)
1
II'II�
OFFICE OF THE TOWN CLERK C3\\FFDt/,�'=
Town of Southold 0�� :•.� �Q '_ Application No.5 fr
Judith T. Terry, Town Clerk . '„ y
Town Hall, 53095 Main Road �`
7 - Residential
• P. -0. Box 1179 cn 0 . i :' Non-Residential
Southold, New York 11971 O s -kr/
Telephone = 2 '1
(516) 765-1801
TOWN OF SOUTHOLD
. SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT •
SEPTIC TANK or CESSPOOL
Operation Permit No. - -
Fee $ /40
DATE ja444.444,7
OWNER NAME: 34,00/2A f /d/3C-72T
OWNER MAILING ADDRESS: )( /t PtiTPjf'L/f} 2i).
MA-TT/
OWNER PROPERTY ADDRESS:. SAME
OWNER TELEPHONE NUMBER: 21g- 8'1' 7
TAX MAP NO. : Section 113 Block / 3 Lot
CROSS STREET:
TYPE OF SYSTEM: Septic Tank New Existing
Cesspool New Existing ,X
Residential $ Non-Residential
DATE OF PREVIOUS PUMP-OUT:
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 BYti&rixik‹.._
n erk's Off ce
DATE: JAN 111987
IMP Clerk Southold
,
:J.-1Z,r,. ' r•rri y 1
1A Qat
Tey
' No c,--lock
4/
w q
Ze Q 11r >R0O .
• r
h 0 . •• ..��'o i`
• kX �4y_ - MAP' o f �ROPERT Y
s
u 6-o• -4"�
7)1
�t + �� G ./ �45� 0 SUR VE YE- FOR
o Qr �r( s'i'.
.�' , '��c-.� f' % ROBERT t` ,BARBARA /V R4ACA E
iSr if)
4: { AT
GI-, �k MATT/TUCK, N V
4,
- . 04.0
iv 5- 1-‘. hb k /
' 4- `, h 4' Q Q i rwaHciWGrr 1
1 0¢ "co"'w 0 • V
�`s`sz� J `' 1. Ce -- ,r f /o 7'k
/fs/cr - Courrfy
C1 ,
77/Ye Gua,-a44 atic/ Mor-tgage Cobir,oufrq
a'5.
ssLcirrceversyW�aodNacjig
. tiaT. u/.Z/7:r c64y�o.
\ \-,
rs
6reLfroor7t-, A/c vv �or k
.