HomeMy WebLinkAboutOrient Congregational Church (2) �,ii#StFFOLit
Off 0
JUDITH T.TERRY ,s=� Gym1 Town Hall, 53095 Main Road
TOWN CLERK ; y P.O. Box 1179
Southold,rt New York 11971
',
REGISTRAR OF VITAL STATISTICS O � � Fax(516) 765-1823
MRIAGE OFFICER
RECORDS�MANAGEMENT OFFICER y*491 � j,' Telephone (516) 765-1800
FREEDOM OF INFORMATION •ODI
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1695 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : GARY TABOR
Address 1 : 680 NAVY STREET
City St Zip ORIENT NY 11957
Descripton of Proposed Construction or Alteration
ADDITION OF 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 ORIENT CONGREGATIONAL CHURCH
Mailing Address 1 MAIN ROAD
City St Zip ORIENT NY 11957
Property Address 1 MAIN ROAD (HOUSE BY CHURCH)
City St Zip ORIENT NY 11957
Tax Map No. section 18.00 block 2 lot 22.001
Cross Street TABOR ROAD
Building Permit Number Cross Reference:
Issue Date: 6/30/97 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
/62 i
? l ll'i 171117 r I
far :c•i
JUS Z 7 1997 0, Town Hall, 53095 Main Road
of GL _ Il�vO P.O. Box 1179
'I'° 'r ryr s ` ``a� Southold, New York 11971
JUDITH T.TERRY ••...�.....— TELEPHONE
TOWN CLERK (516) 765-1801
REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
OA'I F,1): June 27, 1997
Transmitted herewith is a copy of application No. 1765 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Gary Tabor for Orient Congregational 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.
A` l+"
Linda J. Coo:Crt;,
* * * * * * * * * * * * *
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.
gnatur
6/-z....-7 ti-7
Date
A
il
OFFICE OF THE TOWN CLERK
Town of Southold Application No. / 6F-"
Judith T. Terry, Town Clerk .
,4.,.
Town Hail, 53095 Main Road 1 Construction
P. O. Box 1179
Southold, New York 11971 Alteration !/
Telephone ---.71111
!�! `
$10.00 -Residential JO -
(516) 765-1801 - ';" $25,00 -Non-Residential
- l'"
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
CONSTRUCTION or ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No.
Fee $ // //
DATE 6 2 72/p
2
APPLICANT NAME: (...�� 7' / //-.6' 6 0 )---
APPLICANT ADDRESS: L' Er 0' /4-44' 1'N/ S
C oh- ' c 7.
SEPTIC_ CESSPOOL f
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: e. O I'✓, )"-c 9.* 75 10 A./91 /__2 U7^ C i
OWNER MAILING ADDRESS:
69 Pi ' rA-1/4/ 7.
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 323.7. -_, Lf' G 7
TAX MAP NO. : Section i,c--- Block 2- Lot 8; , I
CROSS STREET: 'l JQ A Gr R014 C2
BUILDING PERMIT NUMBER CROSS REFERENCE:
•
-
Signature of Applicant
RECEIVED BY: I I
To n Clerk's ffice
DATE: 6/c . ?7 .
-- j "
t
LIIIII ./
,/ f
/
// --
/ /
Oe_-et'i'c' ,,,..--."
it /II
r�y ('`)��o/,1 s� /� -2,....} �' c) v -e. r • ) 0 0