HomeMy WebLinkAboutMattituck Presbyterian Church (2) OOFFO( c
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JUDITH T.TERRY Is 4 ‘ Town Hall, 53095 Main Road
TOWN CLERK ; y Z P.O. Box 1179
Pt, t Southold, New York 11971
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER 0` y ��II
Fax(516) 765-1823
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RECORDS MANAGEMENT OFFICER 0,( JIFF
`1!.00 Fax
(516) 765-1800
FREEDOM OF INFORMATION OFFICER •z ` �
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1788 R Residential X Non-Residential
Fee $ 10.00 Septic X Cesspool
PERMIT ISSUED TO:
Name : EAST ISLE CUSTOM BUILDERS INC.
Address 1 : 1706 NORTH HIGHWAY
City St Zip SOUTHAMPTON NY 11768
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR SINGLE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-97-0177
Name Of Owner MATTITUCK PRESBYTERIAN CHURCH
Mailing Address 1
City St Zip 0000
Property Address 1 MAIN ROAD
City St Zip MATTITUCK NY 11952
Tax Map No. section 141 .00 block 4 lot 34.000
Cross Street SOUND AVENUE
Building Permit Number Cross Reference:
k, .
Issue Date: 12/31/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
..
• JUDITH T.TERRY ,0 % y1 Town Hall, 53095 Main Road
TOWN CLERK k y i $ P.O. Box 1179
%% v. �t Southold,New York 11971
REGISTRAR OF VITAL STATISTICS :.0y ����0 Fax(516) 765-1823
MARRIAGE OFFICER �Ol ��'11 Telephone Telephone(516) 765-1800
RECORDS MANAGEMENT OFFICER - * „I
FREEDOM OF INFORMATION OFFICER . ii°
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda J. Cooper, Southold Town Clerk's Office
DATED: December 24, 1997
Transmitted herewith is a copy of application No. 1862 for a Cesspool/
Septic Tank Construction Permit submitted by:
East Isle Custom Building for Mattituck Presbyterian Church .
Please review the application and location map and advise if the project
has received Suffolk County Health Department approval and if this office
may issue the permit.
Please complete the form below and return it to me.
Thank you.
Linda J. Coope +r�
* * * * * * * * * * * *
I have reviewed the application and location map of the project cited above
and make the following recd mendations:
APPROVE
DISAPPROVE
Comments:
natur
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Dated
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O(FICEOF THE TOWN CLERK ��1'FFU(/� '''
Town of Southold r'
Application No. /
Judith T. Terry, Town Clerk `?��,�_
Town Hall, 53095 Main Road $10.00 - Residential X
P. O. Box 1179 um $25.00 - Non-Residential _
Southold, New York 11971 O 0� ���•
Telephone
(516) 765-1801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
446 Al
oN 1) Com ' ERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ JO
DATE December 23, 1997
OWNER NAME: Mattituck Presbyterian Church
c/o Builder: East Isle Custom Builders, inc. J __ _.
OWNER MAILING ADDRESS: 1706 N. Highway, Southampton, NY 11968
OWNER PROPERTY ADDRESS: v/s Main Road, 418 s/o Sound Avenue
Mattituck, NY
OWNER TELEPHONE NUMBER: 516-287 -0772
TAX MAP NO. : Section 141 Block 04 Lot 34
CROSS STREET:STREET:_saundAyeake
TYPE OF SYSTEM: Septic Tank New X Existing+_ -
Cesspool New x Existingr-�_ �Yy`
Residential Non-Residential
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.)
8-Zitilti
Signature of Applicant
Richard Oppedisano, President
RECEIVED BY: AZ,
Town Clerk Office
DATE: /4 /4.V/0'
4
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CERTIFIED TO: SURVEY OF
• PRO ER deceived �-
u olk County
SI TU,TE 96C 1 9 1997
EASEMENTS AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED MATTITf 01 Health Services
ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT m TOWN OF 'SAI+��D►water h4
THE TIME OF THE SURVEY. g ••
GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON(S) FOR SUFFOLK COUNTY, NEW YORK
WHOM THE SURVEY IS PREPARED. AND ON HIS BEHALF TO THE TITLE COM-
PANY. GOVERNMENTAL AGENCY AND LENDING INSTITUTIONS LISTED HEREON,
AND TO THE ASSIGNEES OF THE LENDING INSTITUTION. GUARANTEES ARE SCALE 1" = 50' NOVEMBER 14, 1997
NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS.
THE OFFSETS (OR DIMENSIONS) SHOWN HEREON FROM THE STRUCTURES TO
THE LINES ARE FOR A SPECIFICFORE AREERTY NOT INTENDED TO GUIDE THE RECE TIONS OF FENCES,-
AND USE C..) •-/ S.C.T.M. DIST. 1000 SEC. 141 BLK. 04 LOT 34
WALLS. POOLS, PATIOS. PLANTING AREAS, ADDITIONS TO BUILDINGS AND
ANY OTHER CONSTRUCTION.
JOB NO. F969 '. A�FHEp.yo %�i IM " T
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SHOWREV. HSE. & WATER e�
i '!�" A o
REVISIONS: A>� E at
MAIN 12/17/97 P.O. Box 309 • ' .'ontauk Highway
1 rhlT Sayville, N.Y. ,� ;2 H• °ton N.Y. 11946
,.z.• -• (516) 589- 637 (51.) 728-5330
• • Marc E. Chariest, L.S.
,'�`, • With the records of:
tact Paul T. Canalizo, LS. Robert A Kart, LS.
license no. 050149 Good Ground Surveyors, P.C.