HomeMy WebLinkAboutSouthold Presbyterian Church ,/ o o11, OF FOL
JUDITH T.TERRY ; - Town Hall, 53095 Main Road
TOWN CLERK
y Z 1 P.O.Box 1179
REGISTRAR OF VITAL STATISTICS Southold,New York 11971
4 �� Fax(516)765-1823
RECORDS MANAGEMENT OFFICER I
MARRIAGE OFFICER ;;�'0 jig �►*0�8.°� Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER , ••16
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 61 N Residential Non-Residential X
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : MORRIS CESSPOOL SERVICE
Address 1 : .2766 YENNECOTT DRIVE
City St Zip SOUTHOLD NY 11971
Descripton of Proposed Construction or Alteration
ADDITION OF AN OVERFLOW 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 SOUTHOLD PRESBYTERIAN CHURCH
Mailing Address 1 53150 MAIN ROAD
City St Zip SOUTHOLD NY 11971
Property Address 1 53150 MAIN ROAD
City St Zip SOUTHOLD NY 11971
Tax Map No. section 61 .00 block 3 lot 8.004
Cross Street HORTONS LANE
Building Permit Number Cross Reference:
Issue Date: 9/18/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T.TERRY ,1 = a • Town Hall,53095 Main Road
TOWN CLERK t H Z P.O.Box 1179
REGISTRAR OF VITAL STATISTICS V1O 0 Southold,New York 11971
MARRIAGE OFFICER . y� 4 `1►Q� 111 Fax(516)765-1823
RECORDS MANAGEMENT OFFICER of ,$,11Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER .�,,, ,.4°
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: September 15, 1995
Transmitted herewith is a copy of application No. 1445 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Morris Cesspool for Southold 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.
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Date
Signatur
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OFFICE �1F THE TOWN CLERK ,,t' n'�','�
Town of Southold ,,'''i VOL •
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Judith T. Terry, Town Clerk ;` Application No.�y�S
Town Hall, 53095 Main Road Construction
•P. 0.. Box 1179 '
Southold, New York 11971 � Alteration ��
Telephone r ��,�' $10.00 -Residential
(516) 765-1801 _ �' $25.00 -Non-Residential ...,--
TOWN
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee .$
DATE (/I /4-5 411X-)
/
APPLICANT NAME: / ,7`µL .c..-,--c^
APPLICANT ADDRESS:,53/5-0 /726....41_,_ fr1 CQ
SEPTIC CESSPO@t`--f
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION
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LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERA ON:
OWNER OF PROPERTY: ,O/Q( �V
OWNER MAILING ADDRESS: 2 260)‘,(2.4t,../,2_,•_e---Y--
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OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON:
TAX MAP NO. : Section ‘ („ 1 Block q Lot X li
CROSS STREET:
BUILDING PERMIT NUMBER CROSS REFERENCE:
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S5,-,,,,a,ature of Applicant
RECEIVED BY:
TownitelVcr Office
DATE: SEP 1 5 1995
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