HomeMy WebLinkAboutChurch of the Redeemer JUDITH T.TERRY te#� y` Town Hall, 53095 Main Road
TOWN CLERK x ; P.O. Box 1179
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'� Southold,New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER y O� ��� Fax(516)765-1823
RECORDS MANAGEMENT OFFICER '- .� O v,,so Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER - �,,,,••
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 64 N Residential Non-Residential X
Fee $ 25.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : PECONIC CESSPOOL
Address 1 : P. O. BOX 972
City St Zip MATTITUCK NY 11952
Descripton of Proposed Construction or Alteration
ADDITION OF AN OVERFLOW TO AN EXISTING SYSTEM.
APPROVED AS SUBMITTED. MAINTAIN REQUIRED SETBACKS FROM ADJACENT
WELLS, BUILDINGS, PROPERTY LINES AND WATER BODIES. EXCAVATION
INSPECTION REQUIRED.
Name Of Owner CHURCH OF THE REDEEMER
Mailing Address 1 P. O. BOX 906
City St Zip MATTITUCK NY 11952
Property Address 1 13225 SOUND AVENUE
City St Zip MATTITUCK NY 11952
Tax Map No. section 141 .00 block 4 lot 27.000
Cross Street WESTPHALIA AVENUE
Building Permit Number Cross Reference:
Issue Date: 2/13/96 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY i y&.% Town Hall, 53095 Main Road
TOWN CLERK % y = % P.O. Box 1179
rrl ��� Southold,New York 11971
REGISTRAR OF VITAL STATISTICS V /
MARRIAGE OFFICER 4.y.6 0��1� Fax(516) 765-1823
RECORDS MANAGEMENT OFFICER 11 iNg �asiel Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER ..... ..0."
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OFFICE OF THE TOWN CLERK ,
TOWN OF SOUTHOLD 11e
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TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office W ToWWOFSOUTHo!_►J
DATED: January 25, 1996
Transmitted herewith is a copy of application No. A1493 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Peconic Cesspool for Church of the Redeemer
Please review the application and location map and advise if this office may
issue the permit.
Please complete the form below and return it to this office.
Thank you.
, 1-4.,--?t-c .‘,---
Linda
-LjfLrtyLinda J. Cooper
* * * * * * * * * * * * *
I have reviewed the application and location map of the project listed
above and make the following recommendation:
APPROVE -
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED.
Al - - '1---,
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‘ /17‘
Date
OFFICE OF THE TOWN CLERK ,,,'"
Tower'of Southold ' •��FFD�K`+.
Judith T. Terry, Town Clerk � QQ Application No. / 7 /
Town )
Hall, X53095 Main Road 4 _ Construction
P. 0. Box 1179 teration ✓/
Southold, New York 11971 ct� T;
O $10.00 Residential
Telephone - .j' �� - '"
(516) 765-1801 : l �, �' • $25.00 tion-Reside_jaI
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE /7,2-‘,79
APPLICANT C T NA ME: ,'er-,4r)it-e.,
APPLICANT ADDRESS: ,• I /5"P-71 772-
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SEPTIC CESSPOOL
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTIO OR ALTERATION:
OWNER OF PROPERTY: o' ,
�` NER �ING ADDRESS: / 3 ass
OWNER PROPERTY ADDRESS: ,DQ 6 �0
TELEPHONE NUMBER OF CONTACT PERSON: 64*C-7 ---'960g7c-----
TAX MAP NO. : Section /i( Block y Lot c7
CROSS'' STREET: M/ / / Gf'lk2
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BUILDING PERMIT NUMBER CROSS REFERENCE:
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Signature o Applicarl
RECEIVED BY:
Town Clerk's Office
DATE:
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