HomeMy WebLinkAboutProtestant Episcopal Church v I
JUDITH T.TERRY Town Hall,53095 Main Road
TOWN CLERK g P.O.Box 1179
REGISTRAR OF VITAL STATISTICS O 1, Southold,New York 11971
MARRIAGE OFFICER #'f \•' / Fax(516)765-1823
RECORDS MANAGEMENT OFFICER : ®I s2,� V,s��� Telephone(516)765-1800
FREEDOM OF INFORMATION OFFICER
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No. 153-N Residential Non-Residential X
Fee $ 25.00 New Existing X
Name Of Owner PROTESTANT EPISCOPAL CHURCH
Mailing Address 1 THE CHURCH OF THE REDEEMER
Mailing Address 2 P. O. BOX 906
City St Zip MATTITUCK NY 11952-0000
Property Address 1 13225 SOUND AVENUE
Property Address 2
City St Zip MATTITUCK NY 11952-0000
Owner Telephone No. 516-298-4277
Tax Map No. section 141 .00 block 4 lot 27.000
Cross Street WESTPHALIA ROAD
Issue Date: 5/04/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
OFFICE OF THE TOWN CLERK _ SWFDU(
Town of Southold Q C'
Judith T. Terry, Town Clerk �� 0� ` Application No.
Town Hall, 53095 Main Road ! $10.00 - Residential
p. 0. Box 1179 " $25.00 - Non-Residential /53
Southold, New York 11971
Telephone 0 * `NO%'•
(516) "765-1,801
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL DISTRICT
APPLICATION
for
OPERATION PERMIT
SEPTIC TANK or CESSPOOL
Operation Permit No.
Fee $ •
DATE April 24th, 1995
OWNER NAME: The Church of the Redeemer
OWNER MAILING ADDRESS: 1 3225 Sound Avenue , .P. 0. Box 906
Mattituck, New York 11952
OWNER PROPERTY ADDRESS: (same)
OWNER TELEPHONE NUMBER: 1 -516-298-4277 '
TAX MAP NO. : Section Block Lot
CROSS STREET: Westphalia Road-
TYPE OF SYSTEM: Septic Tank x New Existing x
Cesspool x New Existing x
Residential Non-Residential x
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.)
'g ature of Applicant
RECEIVED BY:
Town Clerk's Office
DATE: �D '
MAY 2 1995
Ion Clock Southold
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