HomeMy WebLinkAboutMattituck Presbyterian Church •• \,1 f„F.0.4;
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JUDITH T.TERRY ��' y` Town Hall, 53095 Main Road
TOWN CLERK ; y = P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS ��� Fax (516) 765-1823
yJ�
MARRIAGE OFFICER � ? `0.0. Telephone (516) 765-1800
RECORDS MANAGEMENT OFFICER 1 411 �`
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. 72 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 A NEW CESSPOOL 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 MATTITUCK PRESBYTERIAN CHURCH
Mailing Address 1 P. O. BOX 1411
City St Zip MATTITUCK NY 11952
Property Address 1 MAIN ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 141 .00 block 4 lot 32.001
Cross Street NEW SUFFOLK AVENUE
Building Permit Number Cross Reference:
Issue Date: 5/24/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
,o\OStFFOC�00
JUDITH T.TERRY � _ 4 Town Hall, 53095 Main Road
TOWN CLERK y = P.O. Box 1179
�� Southold,New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER = ifJ 0�'�1�, Fax (516) 765-1823
RECORDS MANAGEMENT OFFICER . 4.1 � i•;8.1 Telephone(516) 765-1800
FREEDOM OF INFORMATION OFFICER '•v„„ ,•SAP I
OFFICE OF THE TOWN CLERK rp..) I T I w
TOWN OF SOUTHOLD
11 MAY 2 1 1996 L
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office TOWN •.DESOt L0LD
DATED: May 21, 1996
Transmitted herewith is a copy of application No. NRA1549 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
PFCONIC CESSPOOL FOR MATTITUCK PRESBYTERIAN CHURCH
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.
Linda 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.
1.
Signatur:
i3/9'-3/57r,
Date
4 e`
OFFICE OF 'THE TOWN' CLERK ""' '-
Town of Southold ,ii"c FfU(K
Judith T. Terry, Town Clerk 1,' � C�l/y Application No. l, q
Town Hall, 53095 Main Road Construction i
P. O. Box 1179 ; o rn
New York 11971 • Alteration
Southold, --_
Telephone ob,>f' ��‘��• $10.00 - Residential
y
(516) 7 65-1801 �l r
,, $25.00 - Non Residential ✓
TOWN OF SOUTHOLD.
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $
DATE 7e////1,1/77/7
APPLICANT NAME: /'
APPLICANT ADDRESS: � /2> Q7 `�
SEPTIC CESSPOOL___.____.
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY:_ �a ..
OWNER MAILING ADDRESS: /�?Ol � /� �v 13,9‘. 1
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: r26 57 V
TAX MAP NO. : Section y/ BlockL Lot 3 a
CROSS STREET: �- -J
BUILDING PERMIT NUMBER CROSS REFERENCE:
Sig i ure of Applicant
RECEIVED BY: `
_
Tow er 's Office
DATE: �_5/c9//9'
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