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HomeMy WebLinkAboutChurch of the Redeemer JUDITH T.TERRY te#� y` Town Hall, 53095 Main Road TOWN CLERK x ; P.O. Box 1179 � '� 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) 4 / (e y 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." u 'fi OFFICE OF THE TOWN CLERK , TOWN OF SOUTHOLD 11e ! jBLDG2.DE6 PT 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---, ' ignatu - - 1 ‘ /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- ,. c //`� 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 C BUILDING PERMIT NUMBER CROSS REFERENCE: M \ ' Y Signature o Applicarl RECEIVED BY: Town Clerk's Office DATE: 4 \. -.., . f 1 Iw 0• `-- Al ✓, • ✓'rk 'b \,,,______:17coid COS/sot PO4.44',.. .1 L.T N