HomeMy WebLinkAboutMattituck Presbyterian Church (5) 0,,,
JUDITH T.TERRY 4 ��`� Town Hall, 53095 Main Road
TOWN CLERK c "''a g t P.O.Box 1179
•
REGISTRAR OF VITAL STATISTICS k� � Southold,New York 11971
Fax(516)765-1823
MARRIAGE OFFICER �� Telephone(516)765-1800
RECORDS MANAGEMENT OFFICER ED ale"
FREEDOM OF INFORMATION OFFICER ,00
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 1323 R Residential X Non-Residential
Fee $ 10.00 Septic Cesspool X
PERMIT ISSUED TO:
Name : RAYMOND NINE
Address 1 : P. O. BOX 1401
City St Zip MATTTIUCK NY 11952
Descripton of Proposed Construction or Alteration
ADDITION OF AN OVERFLOW 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 1 125 REEVE AVENUE
City St Zip MATTITUCK NY 11952
Property Address 1 125 REEVE AVENUE
City St Zip MATTITUCK NY 11952
Tax Map No. section 114.00 block 9 lot 5.000
Cross Street MAIN ROAD
Building Permit Number Cross Reference:
Issue Date: 4/28/95 Judith T. Terry
Southold Town Clerk
(TOWN SEAL)
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JUDITH T. TERRY : ' '' Town Hall, 53095 Main Road
TOWN CLERK : ® " P.O. Box 1179
Southold, New York 11971
REGISTRAR OF VITAL STATISTICS • r Fax (516) 765-1823
MARRIAGE OFFICER -__I )9Or Telephone (516) 765-1801
RECORDS MANAGEMENT OFFICER _7UJ ,
FREEDOM OF INFORMATION OFFICER �
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
TO: Southold Town Building Department
FROM: Linda Cooper, Southold Town Clerk's Office
DATED: April 28, 1995
Transmitted herewith is a copy of application No. 1372 for an
ALTERATION PERMIT for a cesspool or septic system submitted by
Ray Nine 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 reco dation:
APPROVE -
DISAPPROVE -
COMMENTS: Maintain required setbacks from adjacent wells,
buildings, property lines and water bodies. EXCAVATION INSPECTION
REQUIRED. °
/-
. i
Signat e
Date
OFFICE OF THE TOWN CLERK ,,,'""""'-
Town' of Southold �.10 c� Four�►�
Judith T. Terry, Town Clerk I ;' �0 �l/y'4,' Application No. J
Town Hall, 53095 Main Road ; Construction
P. O. Box 1179 Z o nzi ✓�
Southold, New York 11971 :FA Alteration
Telephone ----AO/
0 ����'�, $10.00 - Residential �'
(516) 765-1801 - 'yOl 0,01
�� $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 1/2_ 7 OS
APPLICANT NAME:
APPLICANT ADDRESS: gc$)/j2,/ 1 Ji f^ ftan),--,r ,i, `. vz
SEPTIC CESSPOOL d
DESCRIPTION OF PROPOSED CONSTRUCTION OR ALTERATION /1,,,e14/ j j(e9'
OUCX /,t &-C4/ f 7 s' •
LOCATION MAP: Must be attached hereto before permit may be issued.
LOCATION OF PROPOSED CONSTRUCTION OR ALTERATION:
OWNER OF PROPERTY: hi /I r-,r /7' if c.5 . refs�� ,5)01,9 Cx,,,,`
OWNER MAILING ADDRESS: /aS r •r tib igVA
hi, 7' '/ 76 $‘11,-,V )/,x
OWNER PROPERTY ADDRESS:
TELEPHONE NUMBER OF CONTACT PERSON: 2qf .,f zp-
TAX MAP NO. : Section pill Block q- Lot
CROSS STREET: hi AIN if aof
BUILDING PERMIT NUMBER CROSS REFERENCE:
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RECEIVED BY: (/(1a4------
I__47T` wn Clerk's Office
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